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General NPI Number Information
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NPI Number | 1639618549
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Entity Type | Individual
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Provider Name | JASON BOOKER PT
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Gender | Male
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Dates
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Enumeration Date | 02/13/2017
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 251 W LEE HWY STE 193
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City | WARRENTON
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State | VA
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Zip | 20186-2047
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Country | US
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Telephone | 540-466-3883
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Fax | 540-739-7474
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Provider Business Mailing Address
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Address Line | 350 NEW FIDELITY CT
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City | GARNER
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State | NC
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Zip | 27529-2665
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Country | US
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Telephone | 919-756-3107
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Fax | 919-535-3271
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305210841
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License Number State | VA
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