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NPI Code Detail

MEDICARE: BEN WILLIAM CUDNEY COTA/L

MEDICARE: BEN WILLIAM CUDNEY COTA/L
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 Assistant

General Provider Information

NPI Number : 1326614066
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEN WILLIAM CUDNEY COTA/L
Provider Business Mailing Address
First Line : 2400 W 79TH TER
Second Line :
City : PRAIRIE VILLAGE
State : KS
Zip : 66208-3842
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3910 RAINBOW BLVD
Second Line :
City : KANSAS CITY
State : KS
Zip : 66103-2946
Country : US
Telephone Number : 785-713-1217
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2021
Last Update Date : 06/02/2021

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Directions to “ BEN WILLIAM CUDNEY COTA/L” Practice Location

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