Provider Demographics
NPI:1265767461
Name:COHEN, PERRY (LAC, DIPL AC)
Entity type:Individual
Prefix:MR
First Name:PERRY
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:LAC, DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 BOST AVE
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-3247
Mailing Address - Country:US
Mailing Address - Phone:530-470-8681
Mailing Address - Fax:530-470-8681
Practice Address - Street 1:173 BOST AVE
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-3247
Practice Address - Country:US
Practice Address - Phone:530-470-8681
Practice Address - Fax:530-470-8681
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4066171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist