MEDICARE: DAVID SCOTT COBB OT

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	225X00000X	Occupational Therapist	OT2755	TN

General Provider Information

NPI Number	:	1780843862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID SCOTT COBB OT

Provider Business Mailing Address
First Line	:	505 WILLOW CREEK CV NE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37323-4205
Country	:	US
Telephone Number	:	423-505-8613
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 WILLOW CREEK CV NE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37323-4205
Country	:	US
Telephone Number	:	423-505-8613
Fax Number	:

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

Provider Enumeration Date	:	06/04/2008
Last Update Date	:	10/19/2009

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