Most Relevant Information
Provider Data
| NPI Number: | 1003483165 |
| Provider Name: | VACERA M MACK COTA |
| Entity Type: | Individual |
| Taxonomy Code: | 224ZF0002X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 5202007393 |
Most Important Dates
| Enumeration Date: | 06/08/2021 |
| Last Updated: | 06/08/2021 |
Provider Practice Location
36048 WOODINGHAM ST
CLINTON TOWNSHIP
MI
480351680
Practice Location Phone/Fax
| Phone: | 5862377569 |
| Fax: |
Provider Mailing Location
36048 WOODINGHAM ST
CLINTON TOWNSHIP
MI
480351680
Provider Mailing Phone/Fax
| Phone: | 5862377569 |
| Fax: |