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NPI Code Detail

MEDICARE: JODIE REITZ COTA

MEDICARE: JODIE REITZ 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
1224Z00000XOccupational Therapy Assistant4810CA
2224Z00000XOccupational Therapy Assistant0001191CO

General Provider Information

NPI Number : 1154981405
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODIE REITZ COTA
Provider Business Mailing Address
First Line : 3625 RIALTO HTS # 3-042
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-8631
Country : US
Telephone Number : 559-978-1508
Fax Number :
Provider Business Practice Location Address
First Line : 12105 AMBASSADOR DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80921-3642
Country : US
Telephone Number : 800-335-1060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2019
Last Update Date : 06/18/2019

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Directions to “ JODIE REITZ COTA” Practice Location

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