Most Relevant Information
Provider Data
| NPI Number: | 1003197732 |
| Provider Name: | ELAINE PERRY COTA/L |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | 2435 |
Most Important Dates
| Enumeration Date: | 09/08/2011 |
| Last Updated: | 09/10/2014 |
Provider Practice Location
801 PLEASANT ST
BROCKTON
MA
023013052
Practice Location Phone/Fax
| Phone: | 5085865977 |
| Fax: |
Provider Mailing Location
801 PLEASANT ST
BROCKTON
MA
023013052
Provider Mailing Phone/Fax
| Phone: | 5085865977 |
| Fax: |