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NPI Code Detail

MEDICARE: JILLIAN DAY CAMPBELL COTA/L

MEDICARE: JILLIAN DAY CAMPBELL COTA/L
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 Assistant388454AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1388454OTHERDDD

General Provider Information

NPI Number : 1861966723
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILLIAN DAY CAMPBELL COTA/L
Provider Business Mailing Address
First Line : 7990 E SNYDER RD APT 23202
Second Line :
City : TUCSON
State : AZ
Zip : 85750-9049
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 231 W GIACONDA WAY
Second Line :
City : TUCSON
State : AZ
Zip : 85704-4341
Country : US
Telephone Number : 520-329-8830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2019
Last Update Date : 01/14/2019

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Directions to “ JILLIAN DAY CAMPBELL COTA/L” Practice Location

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