Provider Demographics
NPI:1184007668
Name:COCHRAN, VICTORIA (CSA)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 CAMPBELL HILL ST NW STE 280
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1162
Mailing Address - Country:US
Mailing Address - Phone:903-754-0770
Mailing Address - Fax:
Practice Address - Street 1:833 CAMPBELL HILL ST NW STE 280
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1162
Practice Address - Country:US
Practice Address - Phone:770-485-7628
Practice Address - Fax:678-403-1081
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4475246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant