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NPI Code Detail

MEDICARE: LORI ANN KING COTA

MEDICARE: LORI ANN KING 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 Assistant688-027WI

General Provider Information

NPI Number : 1699826222
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI ANN KING COTA
Provider Business Mailing Address
First Line : W10560 TIPPERARY RD
Second Line :
City : POYNETTE
State : WI
Zip : 53955-9419
Country : US
Telephone Number : 608-635-3820
Fax Number :
Provider Business Practice Location Address
First Line : 245 SYCAMORE ST
Second Line :
City : SAUK CITY
State : WI
Zip : 53583-1013
Country : US
Telephone Number : 608-643-3383
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2007
Last Update Date : 07/08/2007

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Directions to “ LORI ANN KING COTA” Practice Location

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