Provider Demographics
NPI:1437614385
Name:COCHRUN MEDICAL MANAGEMENT
Entity Type:Organization
Organization Name:COCHRUN MEDICAL MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HILLS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:503-967-7874
Mailing Address - Street 1:5167 RIVER RD N
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-5349
Mailing Address - Country:US
Mailing Address - Phone:503-967-7874
Mailing Address - Fax:503-967-7871
Practice Address - Street 1:5167 RIVER RD N
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-5349
Practice Address - Country:US
Practice Address - Phone:503-967-7874
Practice Address - Fax:503-967-7871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy