Healthcare Provider Details

I. General information

NPI: 1841304904
Provider Name (Legal Business Name): RAYMOND STEVEN KOTT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 11/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 S MCCORD RD
HOLLAND OH
43528-8745
US

IV. Provider business mailing address

757 S MCCORD RD
HOLLAND OH
43528-8745
US

V. Phone/Fax

Practice location:
  • Phone: 419-865-1727
  • Fax: 419-865-1707
Mailing address:
  • Phone: 419-865-1727
  • Fax: 419-865-1707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number571
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: