Most Relevant Information
Provider Data
| NPI Number: | 1003216946 |
| Provider Name: | COLE POWELL ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | 2000018604 |
Most Important Dates
| Enumeration Date: | 08/28/2014 |
| Last Updated: | 08/28/2014 |
Provider Practice Location
19455 DEERFIELD AVE STE 312
LEESBURG
VA
201768102
Practice Location Phone/Fax
| Phone: | 7037295010 |
| Fax: |
Provider Mailing Location
12901 LEE JACKSON MEMORIAL HWY
APT. C
FAIRFAX
VA
220332172
Provider Mailing Phone/Fax
| Phone: | 7035778074 |
| Fax: |