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General NPI Number Information
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NPI Number | 1013539071
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Entity Type | Individual
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Provider Name | VERONICA COHEN
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Gender | Female
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Dates
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Enumeration Date | 05/13/2020
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 1103 RUSSELL PKWY
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City | WARNER ROBINS
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State | GA
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Zip | 31088-5537
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Country | US
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Telephone | 478-922-4091
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Fax |
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Provider Business Mailing Address
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Address Line | 1665 WESLEYAN DR APT 302
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City | MACON
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State | GA
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Zip | 31210-0803
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Country | US
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Telephone | 478-228-2515
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM1400X
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Taxonomy Name | Nurse Massage Therapist (NMT)
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License Number | MT003804
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License Number State | GA
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