Most Relevant Information
Provider Data
| NPI Number: | 1003561903 |
| Provider Name: | AMANDA WOTRING COTA/L |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/18/2022 |
| Last Updated: | 02/18/2022 |
Provider Practice Location
6330 N FIR RD
GRANGER
IN
465304753
Practice Location Phone/Fax
| Phone: | 5747770311 |
| Fax: |
Provider Mailing Location
25308 FILLMORE RD
SOUTH BEND
IN
466194557
Provider Mailing Phone/Fax
| Phone: | 5743150767 |
| Fax: |