Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | RT006866 | PA |
Y | 213ES0000X | Sports Medicine | RT006866 | PA |
NPI | 1386131951 |
---|---|
Provider Name | Skyler Nicole Cottrell |
First Address | Colorado Springs, CO 80905-2155 |
Second Address | Coraopolis, PA 15108-3054 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2018 |
Last Update Date | 18/04/2018 |