Provider Demographics
NPI:1417391855
Name:PERRIGO, RHONDA JO (COTA)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:JO
Last Name:PERRIGO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3527 US HIGHWAY 45 S
Mailing Address - Street 2:
Mailing Address - City:PINSON
Mailing Address - State:TN
Mailing Address - Zip Code:38366-9789
Mailing Address - Country:US
Mailing Address - Phone:701-891-9091
Mailing Address - Fax:
Practice Address - Street 1:121 PHYSICIANS DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-6011
Practice Address - Country:US
Practice Address - Phone:731-664-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-27
Last Update Date:2013-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOTA0000002051224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant