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NPI Code Detail

MEDICARE: MRS. RITA GAIL BEACH COTA

MEDICARE: MRS. RITA GAIL BEACH 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 AssistantOTA.02681OH

General Provider Information

NPI Number : 1164628046
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RITA GAIL BEACH COTA
Provider Business Mailing Address
First Line : 2223 21ST ST NE
Second Line :
City : CANTON
State : OH
Zip : 44705-2331
Country : US
Telephone Number : 330-453-2652
Fax Number :
Provider Business Practice Location Address
First Line : 2714 13TH ST NW
Second Line :
City : CANTON
State : OH
Zip : 44708-3121
Country : US
Telephone Number : 330-456-2842
Fax Number : 330-456-5343
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. RITA GAIL BEACH COTA” Practice Location

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