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NPI Code Detail

MEDICARE: KYLE PECHTOLD COTA/L

MEDICARE:   KYLE  PECHTOLD  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 Assistant420414FL
2224Z00000XOccupational Therapy Assistant17247FL

General Provider Information

NPI Number : 1497406524
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE PECHTOLD COTA/L
Provider Business Mailing Address
First Line : 3745 PIAZZA DR APT 210
Second Line :
City : FORT MYERS
State : FL
Zip : 33916-8135
Country : US
Telephone Number : 814-441-8111
Fax Number :
Provider Business Practice Location Address
First Line : 3745 PIAZZA DR APT 210
Second Line :
City : FORT MYERS
State : FL
Zip : 33916-8135
Country : US
Telephone Number : 814-441-8111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2022
Last Update Date : 01/14/2022

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Directions to “ KYLE PECHTOLD COTA/L” Practice Location

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