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NPI Code Detail

MEDICARE: AMY SUE BULLION COTA/L

MEDICARE: AMY SUE BULLION 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 AssistantOTA.04264OH

General Provider Information

NPI Number : 1356686505
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY SUE BULLION COTA/L
Provider Business Mailing Address
First Line : 101 MILLS PLACE
Second Line :
City : NEW LEBANON
State : OH
Zip : 45345
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 101 MILLS PL
Second Line :
City : NEW LEBANON
State : OH
Zip : 45345-1430
Country : US
Telephone Number : 937-687-1311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2012
Last Update Date : 11/29/2012

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