Individual
JACOB LEE COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-6093
Mailing address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-6093
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/09/2017
Last updated
10/18/2023
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