Most Relevant Information
Provider Data
| NPI Number: | 1003047812 |
| Provider Name: | ANDY JOE GILLUM COTA |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | OTA . 04143 |
Most Important Dates
| Enumeration Date: | 07/29/2009 |
| Last Updated: | 07/29/2009 |
Provider Practice Location
2125 ROYCE ST
PORTSMOUTH
OH
456624714
Practice Location Phone/Fax
| Phone: | 7408769232 |
| Fax: | 7408769525 |
Provider Mailing Location
2125 ROYCE ST
PORTSMOUTH
OH
456624714
Provider Mailing Phone/Fax
| Phone: | 7408769232 |
| Fax: | 7408769525 |