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NPI Code Detail

MEDICARE: RACHEL BRIANNE STEWART COTA

MEDICARE: RACHEL BRIANNE STEWART 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 Assistant

General Provider Information

NPI Number : 1295203693
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL BRIANNE STEWART COTA
Provider Business Mailing Address
First Line : 3066 N KENTUCKY ST
Second Line :
City : IOLA
State : KS
Zip : 66749-1951
Country : US
Telephone Number : 620-365-1000
Fax Number :
Provider Business Practice Location Address
First Line : 3066 N KENTUCKY ST
Second Line :
City : IOLA
State : KS
Zip : 66749-1951
Country : US
Telephone Number : 620-365-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2018
Last Update Date : 11/05/2018

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