MEDICARE: HEATHER FOSTER 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
1	174400000X	Specialist	04742	OH

General Provider Information

NPI Number	:	1770930877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER FOSTER COTA/L

Provider Business Mailing Address
First Line	:	6736 MANCHESTER RD
Second Line	:
City	:	NEW FRANKLIN
State	:	OH
Zip	:	44216-9434
Country	:	US
Telephone Number	:	330-858-9455
Fax Number	:

Provider Business Practice Location Address
First Line	:	6736 MANCHESTER RD
Second Line	:
City	:	NEW FRANKLIN
State	:	OH
Zip	:	44216-9434
Country	:	US
Telephone Number	:	330-858-9455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2016
Last Update Date	:	05/18/2016

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Directions to “ HEATHER FOSTER COTA/L” Practice Location

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