MEDICARE: KARI DAWN COCHENOUR DPT, PT, LAT, ATC

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	2255A2300X	Athletic Trainer	36002819A	IN
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1528452281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARI DAWN COCHENOUR DPT, PT, LAT, ATC

Provider Business Mailing Address
First Line	:	510 W SPRING ST
Second Line	:
City	:	BLOOMFIELD
State	:	IN
Zip	:	47424-1112
Country	:	US
Telephone Number	:	812-699-2248
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 W SPRING ST
Second Line	:
City	:	BLOOMFIELD
State	:	IN
Zip	:	47424-1112
Country	:	US
Telephone Number	:	812-699-2248
Fax Number	:

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

Provider Enumeration Date	:	03/20/2015
Last Update Date	:	06/04/2021

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