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NPI Code Detail

MEDICARE: RANDY D COTTRELL OT

MEDICARE:   RANDY D COTTRELL  OT
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1538294327
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDY D COTTRELL OT
Provider Business Mailing Address
First Line : 2222 SULLIVAN TRL
Second Line :
City : EASTON
State : PA
Zip : 18040-7958
Country : US
Telephone Number : 610-991-2034
Fax Number :
Provider Business Practice Location Address
First Line : 1991 SAUL KLEINFELD DR
Second Line :
City : EL PASO
State : TX
Zip : 79936-3757
Country : US
Telephone Number : 610-991-2034
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 07/09/2007

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Directions to “ RANDY D COTTRELL OT” Practice Location

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