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General NPI Number Information
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NPI Number | 1750587929
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Entity Type | Individual
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Provider Name | JOSEPH ROBERT KOVACH COTAL
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Gender | Male
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 700 HELEN ST
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City | CLYDE
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State | OH
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Zip | 43410-2051
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Country | US
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Telephone | 419-547-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 223 N WALNUT ST
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City | WOODVILLE
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State | OH
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Zip | 43469-1155
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Country | US
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Telephone | 419-849-2788
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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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