Provider Demographics
NPI:1174715635
Name:COCHRAN, KAYLA J (RT, RDMS)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:J
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:RT, RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 N GATEWAY DR UNIT 418
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-9851
Mailing Address - Country:US
Mailing Address - Phone:435-881-2828
Mailing Address - Fax:
Practice Address - Street 1:358 N GATEWAY DR UNIT 418
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-9851
Practice Address - Country:US
Practice Address - Phone:435-881-2828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography