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General NPI Number Information
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NPI Number | 1861083412
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Entity Type | Individual
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Provider Name | OLIVIA ANNE COTTON OD
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Gender | Female
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 118 E MAIN ST
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City | PARKSTON
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State | SD
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Zip | 57366-2075
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Country | US
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Telephone | 605-928-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 617 3RD ST SE
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City | WAGNER
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State | SD
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Zip | 57380-9566
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Country | US
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Telephone | 605-680-0914
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 769
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License Number State | SD
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