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1609073873
CAROL J EARL
PORTAGE, IN
NPI
1609073873
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IN 32000220A)
Enumeration Date
2007-06-29
Last Update Date
2007-07-08
Business Address
CAROL J EARL COTA
6040 LUTE RD
PORTAGE, IN 46368-5008
Phone number: 219-763-6858
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Mailing Address
CAROL J EARL COTA
4408 KINGSDALE DR
VALPARAISO, IN 46383-1421
Phone number: 219-462-0755
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