Most Relevant Information
Provider Data
| NPI Number: | 1003676628 |
| Provider Name: | KAITLIN MEGAN VARGO COTA/L |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 5202007993 |
Most Important Dates
| Enumeration Date: | 03/20/2024 |
| Last Updated: | 03/20/2024 |
Provider Practice Location
34901 DIVISION RD
RICHMOND
MI
480621559
Practice Location Phone/Fax
| Phone: | 5867277562 |
| Fax: |
Provider Mailing Location
48722 SUGARBUSH RD
CHESTERFIELD
MI
480473313
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |