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General NPI Number Information
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NPI Number | 1972886919
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Entity Type | Individual
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Provider Name | RHONDA LYNN PUTNAM COTA/L
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Gender | Female
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Dates
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Enumeration Date | 09/26/2011
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Last Update Date | 09/26/2011
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Provider Practice Location Address
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Address Line | 601 SULPHUR SPRINGS RD
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City | GREENVILLE
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State | SC
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Zip | 29617-1621
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Country | US
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Telephone | 864-246-2721
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Fax |
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Provider Business Mailing Address
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Address Line | 706 PATRIOT LN
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City | GREER
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State | SC
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Zip | 29651-5282
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Country | US
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Telephone | 570-250-0463
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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 | 2963
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License Number State | SC
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