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NPI Code Detail

MEDICARE: LISA M WARREN COTAL

MEDICARE: LISA M WARREN COTAL
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 AssistantOTA1212OH

General Provider Information

NPI Number : 1952518276
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA M WARREN COTAL
Provider Business Mailing Address
First Line : 1359 NIAGARA AVE
Second Line :
City : AKRON
State : OH
Zip : 44305-2717
Country : US
Telephone Number : 330-733-7767
Fax Number :
Provider Business Practice Location Address
First Line : 4511 ROCKSIDE RD STE 130
Second Line :
City : INDEPENDENCE
State : OH
Zip : 44131-2199
Country : US
Telephone Number : 216-901-0400
Fax Number : 216-901-0401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 07/08/2007

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