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General NPI Number Information
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NPI Number | 1194564997
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Entity Type | Individual
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Provider Name | ROXANNA L COHEN PT
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Gender | Female
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Dates
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Enumeration Date | 05/21/2024
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 715 MALTMAN DR
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City | GRASS VALLEY
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State | CA
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Zip | 95945
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Country | US
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Telephone | 530-477-5167
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Fax |
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Provider Business Mailing Address
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Address Line | 140 HORIZON CIRCLE
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City | GRASS VALLEY
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State | CA
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Zip | 95945
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Country | US
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Telephone | 530-263-1340
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT18823
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License Number State | CA
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