Provider Demographics
NPI:1649925900
Name:FLORA, COLE (OTR/L)
Entity type:Individual
Prefix:MR
First Name:COLE
Middle Name:
Last Name:FLORA
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4415 BARNSLEY GARDENS WAY
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-0665
Mailing Address - Country:US
Mailing Address - Phone:540-526-7778
Mailing Address - Fax:
Practice Address - Street 1:6850 VERSAR CTR STE 241
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-4148
Practice Address - Country:US
Practice Address - Phone:703-256-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119-009347225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist