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NPI Code Detail

MEDICARE: JODI LEE COLE

MEDICARE: JODI LEE COLE
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
1225200000XPhysical Therapy Assistant5502005880MI

General Provider Information

NPI Number : 1932766110
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODI LEE COLE
Provider Business Mailing Address
First Line : 5048 N RIVERVIEW DR
Second Line :
City : KALAMAZOO
State : MI
Zip : 49004-1540
Country : US
Telephone Number : 269-364-9689
Fax Number :
Provider Business Practice Location Address
First Line : 23770 HOSPITAL ST
Second Line :
City : CASSOPOLIS
State : MI
Zip : 49031-9644
Country : US
Telephone Number : 269-445-3801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2019
Last Update Date : 05/23/2019

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Directions to “ JODI LEE COLE ” Practice Location

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