MEDICARE: MS. JOYCE ELAINE OPPY 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
1	224Z00000X	Occupational Therapy Assistant		IN

General Provider Information

NPI Number	:	1902200215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOYCE ELAINE OPPY COTA

Provider Business Mailing Address
First Line	:	860 N COLORADO ST
Second Line	:
City	:	ANDREWS
State	:	IN
Zip	:	46702-9794
Country	:	US
Telephone Number	:	260-504-1752
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 E PRAIRIE ST
Second Line	:
City	:	WARSAW
State	:	IN
Zip	:	46580-4429
Country	:	US
Telephone Number	:	574-267-8922
Fax Number	:

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

Provider Enumeration Date	:	10/15/2014
Last Update Date	:	10/15/2014

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