MEDICARE: ALYSON COCHRAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist	PTH11696	AL

General Provider Information

NPI Number	:	1124881222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSON COCHRAN

Provider Business Mailing Address
First Line	:	1600 7TH AVE S
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35233-1711
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4670 VINTAGE LN
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35244-2446
Country	:	US
Telephone Number	:	901-581-4124
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2024
Last Update Date	:	02/01/2024

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Directions to “ ALYSON COCHRAN ” Practice Location

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