MEDICARE: DR. PATRICIA E COHEN DC

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	CHIR006407	GA

General Provider Information

NPI Number	:	1659438182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA E COHEN DC

Provider Business Mailing Address
First Line	:	5655 LAKE ACWORTH DRIVE
Second Line	:	SUITE 230
City	:	ACWORTH
State	:	GA
Zip	:	30101
Country	:	US
Telephone Number	:	770-966-8000
Fax Number	:	770-966-1670

Provider Business Practice Location Address
First Line	:	5655 LAKE ACWORTH DRIVE
Second Line	:	SUITE 230
City	:	ACWORTH
State	:	GA
Zip	:	30101
Country	:	US
Telephone Number	:	770-966-8000
Fax Number	:	770-966-1670

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	06/09/2008

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