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1346264215
RUSSELL R OTTO
WATERFORD, CT
NPI
1346264215
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CT 004505)
Enumeration Date
2006-07-26
Last Update Date
2019-10-29
Business Address
RUSSELL R OTTO P.A.
201 BOSTON POST RD
WATERFORD, CT 06385
Phone number: 860-442-0407
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Mailing Address
RUSSELL R OTTO P.A.
201 BOSTON POST RD
WATERFORD, CT 06385-2805
Phone number: 860-442-0407
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