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Individual

MR. LAWERENCE JOSEPH JEFFERSON II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
114 WAYNE PL SE, WASHINGTON, DC 20032-6119
(202) 768-2646
Mailing address
10317 TULIP TREE DR, BOWIE, MD 20721-3704
(240) 602-7730

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
DC
183700000X
Pharmacy Technician
Primary
T24909
MD

Other

Enumeration date
07/07/2022
Last updated
09/29/2023
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