Provider Demographics
NPI:1013179852
Name:STEVEN COHN DC PA
Entity Type:Organization
Organization Name:STEVEN COHN DC PA
Other - Org Name:BACK IN LINE FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MARC
Authorized Official - Last Name:COHN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-933-2663
Mailing Address - Street 1:11500 HIGHWAY 7
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-5173
Mailing Address - Country:US
Mailing Address - Phone:952-933-2663
Mailing Address - Fax:952-933-2673
Practice Address - Street 1:11500 HIGHWAY 7
Practice Address - Street 2:SUITE 201
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-5173
Practice Address - Country:US
Practice Address - Phone:952-933-2663
Practice Address - Fax:952-933-2673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4025111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC03541OtherGROUP MEDICARE ID