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MR. ELDON WAYNE CROUCH COTA

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

Registrant NPI Number: 1598984080

Individual Registrant:
MR. ELDON WAYNE CROUCH COTA
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1406 E PUSHMATAHA ST  BUTLER, AL 36904-2728 US
Tel: 205-459-2394  Fax: --

Contact information for business:
3331 SUMMIT BLVD APT 100 PENSACOLA, FL 32503-8300 US
Tel: 906-360-5967  Fax: --

Registration Information:
NPI: 1598984080
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Occupational Therapy Assistant
AL2716

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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