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NPI Code Detail

MEDICARE: CORRI J CARDEN COTA

MEDICARE: CORRI J CARDEN 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
1225X00000XOccupational Therapist32000761AIN

General Provider Information

NPI Number : 1841417805
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORRI J CARDEN COTA
Provider Business Mailing Address
First Line : 335 WATERCRESS WAY
Second Line :
City : BROWNSBURG
State : IN
Zip : 46112-2163
Country : US
Telephone Number : 317-858-7013
Fax Number :
Provider Business Practice Location Address
First Line : 255 MEADOW DR
Second Line :
City : DANVILLE
State : IN
Zip : 46122-1415
Country : US
Telephone Number : 317-745-5451
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 07/08/2007

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