Provider Demographics
NPI:1427378348
Name:COLE, JOSHUA JARED (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:JARED
Last Name:COLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 GARRISONVILLE RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-1545
Mailing Address - Country:US
Mailing Address - Phone:540-242-4489
Mailing Address - Fax:540-242-4731
Practice Address - Street 1:95 DUNN DR STE 123
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-1503
Practice Address - Country:US
Practice Address - Phone:703-523-9565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV1125AMedicare PIN