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General NPI Number Information
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NPI Number | 1114210556
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Entity Type | Individual
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Provider Name | JANNA MARIE COTTINGAME D.C.
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Gender | Female
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Dates
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Enumeration Date | 05/18/2011
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Last Update Date | 10/31/2013
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Provider Practice Location Address
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Address Line | 3004 W UNIVERSITY BLVD STE 101
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City | DURANT
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State | OK
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Zip | 74701-2999
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Country | US
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Telephone | 580-920-2555
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Fax |
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Provider Business Mailing Address
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Address Line | 1259 N WASHINGTON AVE
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City | DURANT
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State | OK
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Zip | 74701-2119
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Country | US
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Telephone | 580-920-2555
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC4029
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License Number State | OK
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