Organization
MIDLINE MATTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA LANE COOK COTA/L (COTA/L, OWNER)
(479) 746-4100
Entity
Organization
Contact information
Practice address
9108 S HIGHWAY 215, CHARLESTON, AR 72933-8078
(479) 746-4100
Mailing address
9108 S HIGHWAY 215, CHARLESTON, AR 72933-8078
(479) 746-4100
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
04/10/2023
Last updated
03/13/2024
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