Individual
JEROME DEPETRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8601 LASALLE RD, 100, TOWSON, MD 21286-2005
(410) 337-8910
(410) 337-8327
Mailing address
8601 LASALLE ROAD, SUITE 100, TOWSON, MD 21286-2005
(410) 337-8910
(410) 337-8327
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
R2580
MD
Other
Enumeration date
07/02/2014
Last updated
07/02/2014
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