Provider Demographics
NPI:1275740300
Name:COCHRAN TOTAL HEALTH LLC
Entity Type:Organization
Organization Name:COCHRAN TOTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:478-934-8801
Mailing Address - Street 1:PO BOX 845
Mailing Address - Street 2:102 FIRST STREET
Mailing Address - City:COCHRAN
Mailing Address - State:GA
Mailing Address - Zip Code:31014-0845
Mailing Address - Country:US
Mailing Address - Phone:478-934-8801
Mailing Address - Fax:478-934-8642
Practice Address - Street 1:102 1ST ST
Practice Address - Street 2:
Practice Address - City:COCHRAN
Practice Address - State:GA
Practice Address - Zip Code:31014-8713
Practice Address - Country:US
Practice Address - Phone:478-934-8801
Practice Address - Fax:478-934-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty