Most Relevant Information
Provider Data
| NPI Number: | 1003261314 |
| Provider Name: | DILLON TRUMBO COTA |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/25/2016 |
| Last Updated: | 04/25/2016 |
Provider Practice Location
619 S KNIK GOOSE BAY RD
WASILLA
AK
996548075
Practice Location Phone/Fax
| Phone: | 9079823897 |
| Fax: |
Provider Mailing Location
PO BOX 876104
WASILLA
AK
996876104
Provider Mailing Phone/Fax
| Phone: | 9079823897 |
| Fax: |