MEDICARE: HEATHER BUCHTEL 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
1	390200000X	Student in an Organized Health Care Education/Training Program	OTA2230	OH

General Provider Information

NPI Number	:	1023406022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER BUCHTEL COTA/L

Provider Business Mailing Address
First Line	:	62222 FRANKFORT RD
Second Line	:
City	:	SALESVILLE
State	:	OH
Zip	:	43778-9638
Country	:	US
Telephone Number	:	740-679-2111
Fax Number	:	740-679-3288

Provider Business Practice Location Address
First Line	:	65553 WINTERGREEN RD
Second Line	:
City	:	LORE CITY
State	:	OH
Zip	:	43755-9715
Country	:	US
Telephone Number	:	740-489-5100
Fax Number	:	740-489-9049

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2014
Last Update Date	:	12/30/2014

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Directions to “ HEATHER BUCHTEL COTA/L” Practice Location

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