Most Relevant Information
Provider Data
| NPI Number: | 1003277757 |
| Provider Name: | MICHAEL G TODD COTA/L |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 057004150 |
Most Important Dates
| Enumeration Date: | 03/09/2016 |
| Last Updated: | 03/09/2016 |
Provider Practice Location
1601 BUTTERFIELD TRL
KANKAKEE
IL
609012959
Practice Location Phone/Fax
| Phone: | 8159366500 |
| Fax: |
Provider Mailing Location
1601 BUTTERFIELD TRL
KANKAKEE
IL
609012959
Provider Mailing Phone/Fax
| Phone: | 8159366500 |
| Fax: |