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General NPI Number Information
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NPI Number | 1447449178
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Entity Type | Organization
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Legal Business Name | CHARLES M COCHRAN DC PC
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 159 FLETCHER AVE
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City | SPENCER
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State | IN
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Zip | 47460-1521
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Country | US
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Telephone | 812-829-2241
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Fax | 812-829-2242
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Provider Business Mailing Address
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Address Line | PO BOX 111
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City | SPENCER
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State | IN
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Zip | 47460-0111
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES MCCANN COCHRAN II
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Credential | D.C.
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Telephone | 812-829-2241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 08000785A
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License Number State | IN
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