Provider Demographics
NPI:1053517425
Name:PUTNAM, PATRICIA (COTA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:PUTNAM
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 1:508 MAIN ST
Mailing Address - Street 2:BOX 258
Mailing Address - City:PERRY
Mailing Address - State:KS
Mailing Address - Zip Code:66073
Mailing Address - Country:US
Mailing Address - Phone:785-597-5577
Mailing Address - Fax:
Practice Address - Street 1:1501 INVERNESS DR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-1870
Practice Address - Country:US
Practice Address - Phone:785-838-8000
Practice Address - Fax:785-838-8972
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-00135224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant