Lara Jo Gordon COTA/L

NPI 1720417686 - Occupational Therapy Assistant - 224Z00000X

NPI Details
NPI 1720417686
Gender Female
Enumeration Date 11/01/2013
Last Updated 11/01/2013
Entity Type Individual
Active Over 3 years ago
Practice Location
175 BLUEBERRY LN
LACONIA REHABILITATION CENTER
LACONIA NH, 03246, US
Phone (603) 524-3340
Fax
Business Location
14 SUMMER ST APT A
LACONIA NH, 03246-3139, US
Phone (207) 942-3977
Fax
Toxanomy
Taxonomy Code 224Z00000X
License State Idaho
License Number OTA-1267
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According to our database, Lara Jo Gordon COTA/L NPI is 1720417686, taxonomy code is 224Z00000X and license number is OTA-1267, license state is located at Idaho. Lara Jo Gordon COTA/L physically located at 175 Blueberry Ln, Laconia NH, 03246. NPI Number Lara Jo Gordon COTA/L has the Individual type.

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1720417686 NPI number is provided on an as is basis without warranty of any kind. 1720417686 is maintained by the National Plan & Provider Enumeration System. The contents of Lara Jo Gordon COTA/L are for informational purposes only.