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NPI Code Detail

MEDICARE: GRACE SWOOPES COTA

MEDICARE: GRACE SWOOPES COTA
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 Assistant5666AZ

General Provider Information

NPI Number : 1073914354
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE SWOOPES COTA
Provider Business Mailing Address
First Line : 2414 W RAU RIVER RD
Second Line :
City : TUCSON
State : AZ
Zip : 85705-4934
Country : US
Telephone Number : 520-302-7217
Fax Number :
Provider Business Practice Location Address
First Line : 4310 E GRANT RD
Second Line :
City : TUCSON
State : AZ
Zip : 85712-2607
Country : US
Telephone Number : 520-704-6734
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2014
Last Update Date : 09/05/2014

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Directions to “ GRACE SWOOPES COTA” Practice Location

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