Most Relevant Information
Provider Data
| NPI Number: | 1003383282 |
| Provider Name: | JESSICA HARRELL-COOPER |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 5923 |
Most Important Dates
| Enumeration Date: | 10/25/2018 |
| Last Updated: | 10/25/2018 |
Provider Practice Location
14412 JEFFERSON DAVIS HWY
WOODBRIDGE
VA
221912806
Practice Location Phone/Fax
| Phone: | 7034999399 |
| Fax: | 7034999553 |
Provider Mailing Location
6015 BRADMORE ST
ALEXANDRIA
VA
223154712
Provider Mailing Phone/Fax
| Phone: | 8087547652 |
| Fax: |