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Individual

MRS. GARRY CARROLL JELEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
45155 RESEARCH PL, SUITE 140, ASHBURN, VA 20147-4191
(703) 858-0500
(703) 858-5155
Mailing address
45155 RESEARCH PL, SUITE 140, ASHBURN, VA 20147-4191
(703) 858-0500
(703) 858-5155

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004520
VA
363A00000X
Physician Assistant
C05299
MD

Other

Enumeration date
02/02/2012
Last updated
06/02/2014
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