MEDICARE: ANNA MARIA KOTULA DPT

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	225100000X	Physical Therapist	29769	CA

General Provider Information

NPI Number	:	1902868516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA MARIA KOTULA DPT

Provider Business Mailing Address
First Line	:	407 W OJAI AVE
Second Line	:	SUITE C
City	:	OJAI
State	:	CA
Zip	:	93023-2443
Country	:	US
Telephone Number	:	805-646-4906
Fax Number	:	805-624-5987

Provider Business Practice Location Address
First Line	:	407 W OJAI AVE
Second Line	:	SUITE C
City	:	OJAI
State	:	CA
Zip	:	93023
Country	:	US
Telephone Number	:	805-646-4906
Fax Number	:	805-640-8325

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

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	05/30/2018

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