Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Edward John Russell III, COTAL

Individual provider Occupational Therapy Assistant · NPI 1730599226

Mr. Edward John Russell III, COTAL is an Occupational Therapy Assistant in Mesa, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2014

Practice location Address checks out

5358 E Baseline Rd
Mesa, AZ 85206-4716
Phone: (480) 630-3005
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 5776 (AZ)

Record details

NPI number1730599226
Entity typeIndividual (Type 1)
GenderMale
Credentials COTAL
Sole proprietorYes
NPI enumeratedMay 6, 2014
Last updated in NPPESMay 6, 2014

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