MEDICARE: KELSI REINHARD 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
1	224Z00000X	Occupational Therapy Assistant	OTA.05539	OH

General Provider Information

NPI Number	:	1407316417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSI REINHARD COTA/L

Provider Business Mailing Address
First Line	:	PO BOX 232
Second Line	:
City	:	NEW RIEGEL
State	:	OH
Zip	:	44853-0232
Country	:	US
Telephone Number	:	419-618-5549
Fax Number	:

Provider Business Practice Location Address
First Line	:	12 1/2 S. PERRY ST.
Second Line	:
City	:	NEW RIEGEL
State	:	OH
Zip	:	44853-4485
Country	:	US
Telephone Number	:	419-618-5549
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2019
Last Update Date	:	03/25/2019

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Directions to “ KELSI REINHARD COTA/L” Practice Location

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