Individual
ROME WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5357 HAYES ST NE, WASHINGTON, DC 20019-7016
(240) 593-5654
Mailing address
5357 HAYES ST NE, WASHINGTON, DC 20019-7016
(240) 593-5654
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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