# GWINNETT MEDICAL BACK AND NECK PAIN, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386810786
- **Authorized official:** DR. MICHAEL COHEN D.C. (MANAGER)
- **Authorized official phone:** (770) 263-2063

## Contact information

- **Practice address:** 5860 JIMMY CARTER BLVD, SUITE 110, NORCROSS, GA 30071-4662
- **Practice address phone:** (770) 263-2063
- **Practice address fax:** (770) 407-8546
- **Mailing address:** 5860 JIMMY CARTER BLVD, SUITE 110, NORCROSS, GA 30071-4662
- **Mailing address phone:** (770) 263-2063
- **Mailing address fax:** (770) 407-8546

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/06/2008
- **Last updated:** 08/05/2013