NPI 1003216946

Cole Powell, ATC

Practitioner Athletic Trainer Leesburg, VA

Practice location

Address: 19455 Deerfield Ave STE 312, Leesburg, VA 20176-8102
Phone: (703) 729-5010
Mailing address: 12901 Lee Jackson Memorial Hwy APT. C, Fairfax, VA 22033-2172

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 2000018604 (VA)

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Registry record

NPI: 1003216946
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Aug 2014
Record last updated: 28 Aug 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.