Most Relevant Information
Provider Data
| NPI Number: | 1003204876 |
| Provider Name: | DELBERT DEWAYNE PORTER COTA |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 0131000167 |
Most Important Dates
| Enumeration Date: | 01/02/2015 |
| Last Updated: | 01/02/2015 |
Provider Practice Location
787 CRUTCH CREEK LN
DUNGANNON
VA
242453950
Practice Location Phone/Fax
| Phone: | 2764671164 |
| Fax: |
Provider Mailing Location
787 CRUTCH CREEK LN
DUNGANNON
VA
242453950
Provider Mailing Phone/Fax
| Phone: | 2764671164 |
| Fax: |