Provider Demographics
NPI:1558484139
Name:COCHRAN, CHRISTOPHER ALLAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ALLAN
Last Name:COCHRAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E LEGEND CT APT C
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3695
Mailing Address - Country:US
Mailing Address - Phone:440-442-0765
Mailing Address - Fax:
Practice Address - Street 1:34437 CHARDON RD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-9112
Practice Address - Country:US
Practice Address - Phone:440-347-0180
Practice Address - Fax:440-347-0181
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3054111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000477476OtherBLUE CROSS BLUE SHIELD
OH300227097-00OtherBWC NUMBER
OH2211010Medicaid
OHV00223Medicare UPIN
OHCH4035221Medicare ID - Type Unspecified