Provider Demographics
NPI:1295157121
Name:COCHRANE, JOHN WILLIAM (LMT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:COCHRANE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9933
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59904-2933
Mailing Address - Country:US
Mailing Address - Phone:406-871-9885
Mailing Address - Fax:
Practice Address - Street 1:43 WOODLAND PARK DR
Practice Address - Street 2:STE. 20
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4600
Practice Address - Country:US
Practice Address - Phone:406-871-9885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-12
Last Update Date:2014-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1255172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist