MEDICARE: COHEN HEALTH SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1619433000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COHEN HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	285 MOUNT VERNON HWY NE STE A
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-3918
Country	:	US
Telephone Number	:	770-743-4393
Fax Number	:	770-234-5888

Provider Business Practice Location Address
First Line	:	285 MOUNT VERNON HWY NE STE A
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-3918
Country	:	US
Telephone Number	:	770-743-4393
Fax Number	:	770-234-5888

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	DR. BENJAMIN ALEXANDER COHEN
Credential	:	D.C.
Telephone Number	:	770-743-4393

Provider Enumeration Date	:	02/11/2019
Last Update Date	:	02/11/2019

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