Individual
JASON COPPAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMT
Contact information
Practice address
12190 RICHLAND DR, CATHARPIN, VA 20143-1103
(571) 232-7093
Mailing address
12190 RICHLAND DR, CATHARPIN, VA 20143-1103
(571) 232-7093
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019008131
VA
Other
Enumeration date
10/03/2016
Last updated
10/03/2016
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