Provider Demographics
NPI:1578621793
Name:COCHRANE, SCOTT K (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:K
Last Name:COCHRANE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6525 STERLING DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-3475
Mailing Address - Country:US
Mailing Address - Phone:770-513-1313
Mailing Address - Fax:770-513-2461
Practice Address - Street 1:461 W CROGAN ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-4735
Practice Address - Country:US
Practice Address - Phone:770-513-1313
Practice Address - Fax:770-513-2461
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006308111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor