Individual
MISS SAMANTHA COCHRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
3691 WILLOWCREEK RD, PORTAGE, IN 46368-5076
(219) 759-4380
Mailing address
8259 WICKER AVE, SAINT JOHN, IN 46373-8878
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001535A
IN
Other
Enumeration date
03/16/2009
Last updated
03/16/2009
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