Provider Demographics
NPI:1033670401
Name:CARTWRIGHT, DANIEL E (COTA)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:E
Last Name:CARTWRIGHT
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2272 E KEYS AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62702-4343
Mailing Address - Country:US
Mailing Address - Phone:217-801-0261
Mailing Address - Fax:
Practice Address - Street 1:2272 E KEYS AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62702-4343
Practice Address - Country:US
Practice Address - Phone:217-801-0261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant