MEDICARE: MISS EVA M MCQUAIDE C.O.T.A.

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	OTA01122	OH

General Provider Information

NPI Number	:	1467573188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS EVA M MCQUAIDE C.O.T.A.

Provider Business Mailing Address
First Line	:	498 WIRTH AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312-2664
Country	:	US
Telephone Number	:	330-212-9159
Fax Number	:

Provider Business Practice Location Address
First Line	:	4511 ROCKSIDE RD
Second Line	:	SUITE 330
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-2199
Country	:	US
Telephone Number	:	216-986-1731
Fax Number	:

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

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	08/23/2007

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