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NPI Code Detail

MEDICARE: MR. MICHAEL A KOLONICH COTAL

MEDICARE: MR. MICHAEL A KOLONICH COTAL
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 AssistantOTA01765OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326245309
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL A KOLONICH COTAL
Provider Business Mailing Address
First Line : 145 HUNT CLUB DR
Second Line : APT 3C
City : COPLEY
State : OH
Zip : 44321-2912
Country : US
Telephone Number : 330-603-4679
Fax Number :
Provider Business Practice Location Address
First Line : 575 S CLEVELAND MASSILLON RD
Second Line :
City : FAIRLAWN
State : OH
Zip : 44333-3019
Country : US
Telephone Number : 330-666-5866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2007
Last Update Date : 07/08/2007

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