MEDICARE: ANTHONY ROBERT 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	PT012698	GA

General Provider Information

NPI Number	:	1730621657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY ROBERT COCHRAN PT, DPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	866-518-0283
Fax Number	:

Provider Business Practice Location Address
First Line	:	660 LAKE JOY RD STE D
Second Line	:
City	:	KATHLEEN
State	:	GA
Zip	:	31047-2382
Country	:	US
Telephone Number	:	478-313-5385
Fax Number	:	478-313-5429

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

Provider Enumeration Date	:	11/09/2016
Last Update Date	:	01/15/2024

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