Individual
JERRY HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7433 BLAIR RD NW, WASHINGTON, DC 20012-1861
(202) 802-0903
Mailing address
4509 SIMMONS LN, TEMPLE HILLS, MD 20748-3826
(301) 404-8314
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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