Healthcare Provider Details

I. General information

NPI: 1467618207
Provider Name (Legal Business Name): STEVE ALLEN HOGAN COTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3740 OLD HARTFORD RD
OWENSBORO KY
42303-1727
US

IV. Provider business mailing address

3740 OLD HARTFORD RD
OWENSBORO KY
42303-1727
US

V. Phone/Fax

Practice location:
  • Phone: 270-684-7259
  • Fax: 270-684-7275
Mailing address:
  • Phone: 270-684-7259
  • Fax: 270-684-7275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberKY-A3419
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: