Provider Demographics
NPI:1922166057
Name:COHEN, LAWRENCE BRUCE (OD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:BRUCE
Last Name:COHEN
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:2222 CHIMNEY SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-6387
Mailing Address - Country:US
Mailing Address - Phone:770-992-3624
Mailing Address - Fax:770-992-3512
Practice Address - Street 1:6015B ROSWELL RD NE
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4005
Practice Address - Country:US
Practice Address - Phone:404-705-4283
Practice Address - Fax:404-250-1618
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA931-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist