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NPI Code Detail

MEDICARE: MRS. SUSAN RENEE LYONS COTA/L

MEDICARE: MRS. SUSAN RENEE LYONS 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 AssistantOP003184LPA

General Provider Information

NPI Number : 1982998035
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN RENEE LYONS COTA/L
Provider Business Mailing Address
First Line : 10 VO TECH DR
Second Line :
City : OIL CITY
State : PA
Zip : 16301-3502
Country : US
Telephone Number : 814-616-8686
Fax Number : 814-676-0329
Provider Business Practice Location Address
First Line : 10 VO TECH DR
Second Line :
City : OIL CITY
State : PA
Zip : 16301-3502
Country : US
Telephone Number : 814-676-8686
Fax Number : 814-676-0329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2011
Last Update Date : 06/07/2011

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