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NPI Code Detail

MEDICARE: JOSEPH WAYNE KONOP COTA

MEDICARE:   JOSEPH WAYNE KONOP  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 Assistant5258-27WI

General Provider Information

NPI Number : 1447054200
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH WAYNE KONOP COTA
Provider Business Mailing Address
First Line : 508 E CONRAD DR
Second Line :
City : MEDFORD
State : WI
Zip : 54451-2037
Country : US
Telephone Number : 507-319-7894
Fax Number :
Provider Business Practice Location Address
First Line : 650 PEARL ST
Second Line :
City : RIB LAKE
State : WI
Zip : 54470-9322
Country : US
Telephone Number : 715-443-5921
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2025
Last Update Date : 04/02/2025

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Directions to “ JOSEPH WAYNE KONOP COTA” Practice Location

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