Individual
JENNIFER COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4707 OLLEY LN, FAIRFAX, VA 22032-2133
(254) 458-9512
Mailing address
4707 OLLEY LN, FAIRFAX, VA 22032-2133
(254) 458-9512
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/12/2020
Last updated
06/03/2020
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