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NPI Code Detail

MEDICARE: FRANK DAVID BURNS COTA

MEDICARE: FRANK DAVID BURNS 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 Assistant5744NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15744OTHERNCNCBOT LICENSE #
21075558OTHERNCNBCOT CERTIFICATION #

General Provider Information

NPI Number : 1669648705
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRANK DAVID BURNS COTA
Provider Business Mailing Address
First Line : 2702 FARRELL RD
Second Line :
City : SANFORD
State : NC
Zip : 27330-6505
Country : US
Telephone Number : 919-770-9602
Fax Number : 919-774-8523
Provider Business Practice Location Address
First Line : 2702 FARRELL RD
Second Line :
City : SANFORD
State : NC
Zip : 27330-6505
Country : US
Telephone Number : 919-770-9602
Fax Number : 919-774-8523
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2008
Last Update Date : 05/07/2008

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