Individual
A. DALE COCHRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
205 GOLDENEYE CT, SAINT PETERS, MO 63376-5034
(636) 387-0081
Mailing address
205 GOLDENEYE CT, SAINT PETERS, MO 63376-5034
(636) 387-0081
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
6754-11125
MO
Other
Enumeration date
12/17/2008
Last updated
12/17/2008
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