Most Relevant Information
Provider Data
| NPI Number: | 1003650698 |
| Provider Name: | BREVAN ALAN BOWMAN COTA |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | OT-A2027 |
Most Important Dates
| Enumeration Date: | 06/19/2024 |
| Last Updated: | 06/19/2024 |
Provider Practice Location
1699 RED WOLF BLVD
JONESBORO
AR
724015442
Practice Location Phone/Fax
| Phone: | 8703360021 |
| Fax: |
Provider Mailing Location
5056 ABERDEEN RD
JONESBORO
AR
724058184
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |