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General NPI Number Information
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NPI Number | 1053734426
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Entity Type | Individual
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Provider Name | CHRISTOPHER MARK TURNER COTA
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Gender | Male
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Dates
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Enumeration Date | 01/21/2014
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Last Update Date | 01/21/2014
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Provider Practice Location Address
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Address Line | 18 W WASHINGTON AVE
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City | LOVINGTON
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State | NM
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Zip | 88260-4023
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Country | US
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Telephone | 575-739-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 18 W WASHINGTON AVE
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City | LOVINGTON
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State | NM
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Zip | 88260-4023
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Country | US
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Telephone | 575-739-2200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 1223
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License Number State | NM
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