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NPI Code Detail

MEDICARE: JULIE ANN REDFEARN COTA

MEDICARE: JULIE ANN REDFEARN 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 Assistant1004WI

General Provider Information

NPI Number : 1437107240
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE ANN REDFEARN COTA
Provider Business Mailing Address
First Line : 880 INDEPENDENCE LN
Second Line :
City : SAUK CITY
State : WI
Zip : 53583-1381
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 880 INDEPENDENCE LN
Second Line :
City : SAUK CITY
State : WI
Zip : 53583-1381
Country : US
Telephone Number : 608-643-2343
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 07/08/2007

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Directions to “ JULIE ANN REDFEARN COTA” Practice Location

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