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BRANTLEY WARREN DAVIS COTA

>> Occupational Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1003191461

Individual Registrant:
 BRANTLEY WARREN DAVIS COTA
Gender: M
Sole Proprietor

Location and contact information for practice:
19 N MILL ST  SUMRALL, MS 39482-4035 US
Tel: 601-466-9638  Fax: --

Contact information for business:
19 N MILL ST  SUMRALL, MS 39482-4035 US
Tel: --  Fax: --

Registration Information:
NPI: 1003191461
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Occupational Therapy Assistant
TX211203

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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