Healthcare Provider Details

I. General information

NPI: 1639082183
Provider Name (Legal Business Name): MORGAN COCHRAN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7930 BIG BEND BLVD STE H
SAINT LOUIS MO
63119-2718
US

IV. Provider business mailing address

7930 BIG BEND BLVD STE H
SAINT LOUIS MO
63119-2718
US

V. Phone/Fax

Practice location:
  • Phone: 314-961-1807
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2026046337
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: