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General NPI Number Information
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NPI Number | 1215465331
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Entity Type | Individual
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Provider Name | AMANDA PATANIO COTA
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Gender | Female
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Dates
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Enumeration Date | 06/02/2017
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Last Update Date | 06/02/2017
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Provider Practice Location Address
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Address Line | 615 RIDGE RD PERSON MEMORIAL HOSPITAL
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City | ROXBORO
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State | NC
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Zip | 27573
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Country | US
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Telephone | 336-599-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 EAGLE LAKE TRL APT 304
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City | PORT ORANGE
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State | FL
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Zip | 32129-4192
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Country | US
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Telephone |
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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 |
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License Number State |
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