Most Relevant Information
Provider Data
| NPI Number: | 1003634098 |
| Provider Name: | TYLER BEALL COTA |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | OTA-3791 |
Most Important Dates
| Enumeration Date: | 09/30/2024 |
| Last Updated: | 09/30/2024 |
Provider Practice Location
14 C E MORRISON LN
WIGGINS
MS
395778949
Practice Location Phone/Fax
| Phone: | 6013256390 |
| Fax: |
Provider Mailing Location
14 C E MORRISON LN
WIGGINS
MS
395778949
Provider Mailing Phone/Fax
| Phone: | 6013256390 |
| Fax: |