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NPI Code Detail

MEDICARE: MRS. LEKESHA RENEE LAND COTA/L

MEDICARE: MRS. LEKESHA RENEE LAND 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 Assistant6809NC

General Provider Information

NPI Number : 1811152093
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LEKESHA RENEE LAND COTA/L
Provider Business Mailing Address
First Line : 426 WEDGEWOOD ARMS
Second Line :
City : GREENVILLE
State : NC
Zip : 27858-5956
Country : US
Telephone Number : 252-258-1142
Fax Number :
Provider Business Practice Location Address
First Line : 1075 US HIGHWAY 17 S
Second Line :
City : ELIZABETH CITY
State : NC
Zip : 27909-7628
Country : US
Telephone Number : 252-338-3975
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2008
Last Update Date : 07/27/2008

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