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NPI Code Detail

MEDICARE: AMY JONES COTA

MEDICARE: AMY JONES 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 Assistant32001124AIN

General Provider Information

NPI Number : 1255538609
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY JONES COTA
Provider Business Mailing Address
First Line : 30521 ALEX LN
Second Line :
City : ELKHART
State : IN
Zip : 46516-7007
Country : US
Telephone Number : 574-674-6412
Fax Number :
Provider Business Practice Location Address
First Line : 1950 RIDGEDALE RD
Second Line :
City : SOUTH BEND
State : IN
Zip : 46614-2243
Country : US
Telephone Number : 574-291-6722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2007
Last Update Date : 07/08/2007

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