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NPI Code Detail

MEDICARE: KRISTEN KAYE BACHMAN COTA

MEDICARE: KRISTEN KAYE BACHMAN 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
1224ZL0004XLow Vision Occupational Therapy Assistant5202005800MI

General Provider Information

NPI Number : 1699276386
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN KAYE BACHMAN COTA
Provider Business Mailing Address
First Line : 63046 66TH AVE
Second Line :
City : HARTFORD
State : MI
Zip : 49057-8664
Country : US
Telephone Number : 269-208-1703
Fax Number :
Provider Business Practice Location Address
First Line : 4368 CLEVELAND AVE
Second Line :
City : STEVENSVILLE
State : MI
Zip : 49127-9595
Country : US
Telephone Number : 269-983-6501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2018
Last Update Date : 02/27/2018

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Directions to “ KRISTEN KAYE BACHMAN COTA” Practice Location

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