Jerry Cowart

NPI 1841858305 · on the registry since 2019

Practice

Address: 8500 Executive Park Ave Ste 300
Fairfax, VA 22031
Phone: (703) 698-7117
Fax: (703) 698-5729
Organisation at this address: All Pro Dental Care
Roberts Home Medical Llc
Wynn Wellness Center Llc
Wynn Wellness Center, Llc
Resurgent Sports Rehab Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 67

Registry record

Primary taxonomy: 111N00000X
111N00000X
Licence states on file: VA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2019-05-30

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia