Provider Demographics
NPI:1770671364
Name:COHEN, STEVEN CRAIG (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:CRAIG
Last Name:COHEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8493 BREEZY HILL DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-4897
Mailing Address - Country:US
Mailing Address - Phone:561-251-3841
Mailing Address - Fax:
Practice Address - Street 1:5458 TOWN CENTER RD
Practice Address - Street 2:SUITE 104
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1089
Practice Address - Country:US
Practice Address - Phone:561-961-5695
Practice Address - Fax:561-961-5899
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88510OtherBLUE CROSS BLUE SHIELD