MEDICARE: DR. MORGAN COCHRAN PT, DPT

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	PT5419	NM

General Provider Information

NPI Number	:	1679027429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MORGAN COCHRAN PT, DPT

Provider Business Mailing Address
First Line	:	3401 E 30TH ST
Second Line	:
City	:	FARMINGTON
State	:	NM
Zip	:	87402-8805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3401 E 30TH ST
Second Line	:
City	:	FARMINGTON
State	:	NM
Zip	:	87402-8805
Country	:	US
Telephone Number	:	505-324-9840
Fax Number	:

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

Provider Enumeration Date	:	08/10/2016
Last Update Date	:	01/25/2024

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