Provider Demographics
NPI:1205195518
Name:COTTON ORTHOTIC AND PROSTHETIC ASSOCIATES, LLC
Entity Type:Organization
Organization Name:COTTON ORTHOTIC AND PROSTHETIC ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/CPO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:COTTON
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:913-338-2672
Mailing Address - Street 1:6311 W 110TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1509
Mailing Address - Country:US
Mailing Address - Phone:913-338-2672
Mailing Address - Fax:913-338-1776
Practice Address - Street 1:6311 W 110TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1509
Practice Address - Country:US
Practice Address - Phone:913-338-2672
Practice Address - Fax:913-338-1776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-07
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS6684110001OtherMEDICARE PTAN