Provider Demographics
NPI:1902147721
Name:ZIMMERMAN, JILL (COTA)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:ZIMMERMAN
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 1:2801 COHO STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713
Mailing Address - Country:US
Mailing Address - Phone:608-273-3232
Mailing Address - Fax:608-237-8558
Practice Address - Street 1:2801 COHO STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713
Practice Address - Country:US
Practice Address - Phone:608-273-3232
Practice Address - Fax:608-237-8558
Is Sole Proprietor?:No
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant