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NPI Code Detail

MEDICARE: MRS. PORTIA EILEEN JONES COTA

MEDICARE: MRS. PORTIA EILEEN 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 Assistant004921MO

General Provider Information

NPI Number : 1356559314
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PORTIA EILEEN JONES COTA
Provider Business Mailing Address
First Line : 429 NW SHERWOOD DR
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64014-1244
Country : US
Telephone Number : 816-220-3864
Fax Number :
Provider Business Practice Location Address
First Line : 111 NW MOCK AVE
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64014-2503
Country : US
Telephone Number : 816-228-5655
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 07/08/2007

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