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Individual

KELLEY D COCHRAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
607 S MAYO TRL STE B, PAINTSVILLE, KY 41240-1250
(606) 789-6464
(606) 789-6466
Mailing address
PO BOX 1595, ASHLAND, KY 41105-1595
(606) 408-9571
(606) 408-6061

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA221
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100107730
KY
Enumeration date
10/17/2006
Last updated
02/02/2022
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