Healthcare Provider Details

I. General information

NPI: 1932369782
Provider Name (Legal Business Name): MICHAEL THOMAS SCHULER COTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 HIGH ST
SOUTH PARIS ME
04281-6507
US

IV. Provider business mailing address

29 GLENDALE CIR
SCARBOROUGH ME
04074-9146
US

V. Phone/Fax

Practice location:
  • Phone: 207-743-6300
  • Fax: 207-743-8956
Mailing address:
  • Phone: 207-883-8635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOA813
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: