Most Relevant Information
Provider Data
NPI Number: | 1003464413 |
Provider Name: | ALLIAH M IQBAL COTA |
Entity Type: | Individual |
Taxonomy Code: | 224Z00000X |
Specialty: | Occupational Therapy Assistant |
License Number: | 057.005234 |
Most Important Dates
Enumeration Date: | 08/28/2019 |
Last Updated: | 08/28/2019 |
Provider Practice Location
2390 S LOST BRIDGE RD
DECATUR
IL
625214653
Practice Location Phone/Fax
Phone: | 2176200687 |
Fax: |
Provider Mailing Location
2390 S LOST BRIDGE RD
DECATUR
IL
625214653
Provider Mailing Phone/Fax
Phone: | 2176200687 |
Fax: |