MEDICARE: AUSTIN ROBERT FIECHTER COTA

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	224Z00000X	Occupational Therapy Assistant
2	224Z00000X	Occupational Therapy Assistant	32002030A	IN
3	224ZE0001X	Environmental Modification Occupational Therapy Assistant
4	224ZF0002X	Feeding, Eating & Swallowing Occupational Therapy Assistant
5	224ZL0004X	Low Vision Occupational Therapy Assistant
6	224ZR0403X	Driving and Community Mobility Occupational Therapy Assistant

General Provider Information

NPI Number	:	1154686616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUSTIN ROBERT FIECHTER COTA

Provider Business Mailing Address
First Line	:	2601 E CENTER DR
Second Line	:
City	:	BLUFFTON
State	:	IN
Zip	:	46714-9249
Country	:	US
Telephone Number	:	260-804-2079
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 HENRY ST
Second Line	:
City	:	NORTH VERNON
State	:	IN
Zip	:	47265-1095
Country	:	US
Telephone Number	:	812-346-9333
Fax Number	:

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

Provider Enumeration Date	:	07/11/2012
Last Update Date	:	07/11/2012

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