Most Relevant Information
Provider Data
| NPI Number: | 1003372574 |
| Provider Name: | SHELBY LILES COTA |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/20/2019 |
| Last Updated: | 02/20/2019 |
Provider Practice Location
111 NW MOCK AVE
BLUE SPRINGS
MO
640142503
Practice Location Phone/Fax
| Phone: | 8162285655 |
| Fax: |
Provider Mailing Location
9239 MOUNT ZION RD
ODESSA
MO
640766121
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |