Most Relevant Information
Provider Data
| NPI Number: | 1003469388 |
| Provider Name: | LUIS FERNANDO MEJIA COTA |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | A02647 |
Most Important Dates
| Enumeration Date: | 07/16/2019 |
| Last Updated: | 07/16/2019 |
Provider Practice Location
7355 E FURNACE BRANCH RD
GLEN BURNIE
MD
210607060
Practice Location Phone/Fax
| Phone: | 4107663460 |
| Fax: | 4107606947 |
Provider Mailing Location
7355 E FURNACE BRANCH RD
GLEN BURNIE
MD
210607060
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |