Healthcare Provider Details

I. General information

NPI: 1831232107
Provider Name (Legal Business Name): COHEN CHIROPRACTIC CLINIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 MARKET ST
KINGSTON PA
18704-5418
US

IV. Provider business mailing address

417 MARKET ST
KINGSTON PA
18704-5418
US

V. Phone/Fax

Practice location:
  • Phone: 570-283-1011
  • Fax: 570-283-1465
Mailing address:
  • Phone: 570-283-1011
  • Fax: 570-283-1465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC003001L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberDC003001L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC003001L
License Number StatePA

VIII. Authorized Official

Name: DR. RICHARD COHEN
Title or Position: PRESIDENT
Credential: D.C.
Phone: 570-283-1011