Individual
JESSICA HARRELL-COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14412 JEFFERSON DAVIS HWY, WOODBRIDGE, VA 22191-2806
(703) 499-9399
(703) 499-9553
Mailing address
6015 BRADMORE ST, ALEXANDRIA, VA 22315-4712
(808) 754-7652
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605256
VA
225200000X
Physical Therapy Assistant
5923
ID
Other
Enumeration date
10/25/2018
Last updated
10/25/2018
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