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General NPI Number Information
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NPI Number | 1750845616
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Entity Type | Individual
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Provider Name | DENNY E BISCHOF COTA/L
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Gender | Male
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Dates
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Enumeration Date | 01/24/2019
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Last Update Date | 01/24/2019
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Provider Practice Location Address
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Address Line | 903 W MAIN ST
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City | YADKINVILLE
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State | NC
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Zip | 27055-7807
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Country | US
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Telephone | 336-679-8863
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Fax |
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Provider Business Mailing Address
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Address Line | 3510 WIMBERLY LN
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City | WINSTON SALEM
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State | NC
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Zip | 27106-4454
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Country | US
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Telephone | 786-515-4881
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 11465
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License Number State | NC
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