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NPI Code Detail

MEDICARE: LEEANNA MAE RUPRECHT COTA

MEDICARE: LEEANNA MAE RUPRECHT 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 Assistant4520-27WI

General Provider Information

NPI Number : 1407373335
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEEANNA MAE RUPRECHT COTA
Provider Business Mailing Address
First Line : 4481 S RIVORD RD
Second Line :
City : SUPERIOR
State : WI
Zip : 54880-8092
Country : US
Telephone Number : 715-699-5993
Fax Number :
Provider Business Practice Location Address
First Line : 35 N 28TH ST
Second Line :
City : SUPERIOR
State : WI
Zip : 54880-5557
Country : US
Telephone Number : 715-392-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2017
Last Update Date : 08/22/2017

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Directions to “ LEEANNA MAE RUPRECHT COTA” Practice Location

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