Individual
JENNIFER LYNN COTTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT ASST
Contact information
Practice address
302 E 24TH ST, BRYAN, TX 77803-5303
(979) 822-6467
(979) 821-9448
Mailing address
PO BOX 4588, BRYAN, TX 77805-4588
(979) 822-6467
(979) 821-9448
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2071836
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2071836
TEXAS LICENSE
TX
Enumeration date
09/25/2009
Last updated
09/25/2009
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