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NPI Code Detail

MEDICARE: HEATHER SUTTON BANKS COTA/L

MEDICARE: HEATHER SUTTON BANKS COTA/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant3344NC

General Provider Information

NPI Number : 1003082249
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER SUTTON BANKS COTA/L
Provider Business Mailing Address
First Line : 200 HAMPTON WOODS COMPLEX
Second Line :
City : JACKSON
State : NC
Zip : 27845-9503
Country : US
Telephone Number : 252-534-4521
Fax Number : 252-534-4521
Provider Business Practice Location Address
First Line : 200 HAMPTON WOODS COMPLEX
Second Line :
City : JACKSON
State : NC
Zip : 27845-9503
Country : US
Telephone Number : 252-534-4521
Fax Number : 252-534-4521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2008
Last Update Date : 05/07/2008

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Directions to “ HEATHER SUTTON BANKS COTA/L” Practice Location

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