Provider Demographics
NPI:1245268150
Name:COHN, JEFFREY MITCHELL (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MITCHELL
Last Name:COHN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JEFFREY
Other - Middle Name:MITCHELL
Other - Last Name:COHN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:211 SPYGLASS LN
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-6106
Mailing Address - Country:US
Mailing Address - Phone:337-988-2225
Mailing Address - Fax:337-988-0155
Practice Address - Street 1:3804 JOHNSTON ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3851
Practice Address - Country:US
Practice Address - Phone:337-988-2225
Practice Address - Fax:337-988-0155
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA587111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAH2338OtherBLUE CROSS