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NPI Code Detail

MEDICARE: BRIANNA N PETTY COTA/L

MEDICARE: BRIANNA N PETTY COTA/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant2426OK

General Provider Information

NPI Number : 1063148468
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIANNA N PETTY COTA/L
Provider Business Mailing Address
First Line : 501 S COLTRANE RD STE A
Second Line :
City : EDMOND
State : OK
Zip : 73034-6729
Country : US
Telephone Number : 580-318-9415
Fax Number :
Provider Business Practice Location Address
First Line : 501 S COLTRANE RD STE A
Second Line :
City : EDMOND
State : OK
Zip : 73034-6729
Country : US
Telephone Number : 580-318-9415
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2022
Last Update Date : 08/08/2025

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Directions to “ BRIANNA N PETTY COTA/L” Practice Location

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