MEDICARE: KYA CRUSHEA 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	225100000X	Physical Therapist	PT018153	GA

General Provider Information

NPI Number	:	1356200141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYA CRUSHEA COCHRAN

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	4319 HARTLEY BRIDGE RD STE 150
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31216-5866
Country	:	US
Telephone Number	:	478-333-5111
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ KYA CRUSHEA COCHRAN ” Practice Location

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