DEREK THOMAS EDLIN

BRANDENBURG, KY
NPI1619174729
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: KY  A3750)
Enumeration Date2007-07-02
Last Update Date2007-07-08
Business Address
Mr. DEREK THOMAS EDLIN COTA
814 OLD EKRON RD
BRANDENBURG, KY 40108-1149
Phone number: 270-422-2148
Mailing Address
Mr. DEREK THOMAS EDLIN COTA
99 MADISON AVENUE
BRANDENBURG, KY 40108
Phone number: 270-828-8059