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NPI Code Detail

MEDICARE: HATTIE FRAZIER COTA/L

MEDICARE: HATTIE FRAZIER 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 AssistantC1728WV

General Provider Information

NPI Number : 1508193749
Entity Type Code : Individual
Provider Name (Legal Business Name) : HATTIE FRAZIER COTA/L
Provider Business Mailing Address
First Line : 102 BEECHWOOD AVE
Second Line :
City : WINFIELD
State : WV
Zip : 25213-9557
Country : US
Telephone Number : 304-552-1412
Fax Number :
Provider Business Practice Location Address
First Line : 4000 OUT LOOK DR
Second Line :
City : HURRICANE
State : WV
Zip : 25526-9467
Country : US
Telephone Number : 304-757-4102
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2009
Last Update Date : 11/09/2009

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Directions to “ HATTIE FRAZIER COTA/L” Practice Location

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