Individual
COLE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
19455 DEERFIELD AVE STE 312, LEESBURG, VA 20176-8102
(703) 729-5010
Mailing address
12901 LEE JACKSON MEMORIAL HWY, APT. C, FAIRFAX, VA 22033-2172
(703) 577-8074
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000018604
VA
Other
Enumeration date
08/28/2014
Last updated
08/28/2014
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