Healthcare Provider Details

I. General information

NPI: 1174445993
Provider Name (Legal Business Name): ZACHARY LEE CANNELLA COTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 COMPTON RD
MURFREESBORO TN
37130-1352
US

IV. Provider business mailing address

356 CAMARGUE CT
SMYRNA TN
37167-6554
US

V. Phone/Fax

Practice location:
  • Phone: 615-895-8850
  • Fax:
Mailing address:
  • Phone: 815-354-0990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number4013
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: