Healthcare Provider Details

I. General information

NPI: 1982803060
Provider Name (Legal Business Name): CAROL NEWTON COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2081 LANGHORNE RD
LYNCHBURG VA
24501-1443
US

IV. Provider business mailing address

7900D STEVENS MILL RD #160
MATTHEWS NC
28104-2929
US

V. Phone/Fax

Practice location:
  • Phone: 434-846-8437
  • Fax:
Mailing address:
  • Phone: 704-577-6877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: