person
Ryan Otto
Medical Physician Assistant in Kenosha, Wisconsin
NPI 1457004517

Ryan Otto is a Medical Physician Assistant based in Kenosha, WI and is specialized in Medical. Ryan Otto practices in Kenosha, WI. The NPI Number for Ryan Otto is 1457004517 and holds a License No. IL (Wisconsin).

The current practice location address for Ryan Otto is 1400 43Rd St, Kenosha, WI and can be reached out via phone at 414-651-2814.

Location: 1400 43Rd St, Kenosha, WI, 53140-2741
person
Provider Profile Details
NPI Number
1457004517
Provider Name
Ryan Otto
Credential
Provider Entity Type
Individual
Gender
Male
Address
1400 43Rd St, Kenosha, WI, 53140-2741
Phone Number
414-651-2814
Fax Number
Provider Enumeration Date
01/30/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1400 43Rd St
City
State
Zip
53140-2741
Phone Number
414-651-2814
Fax Number
person
Provider Business Mailing Address Details
Address
1400 43Rd St
City
State
Zip
53140-2741
Phone Number
414-651-2814
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
IL (Illinois)
Definition
Definition to come...
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