Individual
JESSICA COULTRIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1106 ALSTON AVE STE 120, FORT WORTH, TX 76104-4622
(832) 320-3193
Mailing address
3902 COUNTRY CLUB RD, ARLINGTON, TX 76013-3046
(682) 459-1614
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2159757
TX
Other
Enumeration date
01/26/2022
Last updated
01/26/2022
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