Individual
JACK S DJIKIAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3611 AUTUMN GLEN CIRCLE, BURTONSVILLE, MD 20866
(240) 645-5101
Mailing address
3611 AUTUMN GLEN CIRCLE, BURTONSVILLE, MD 20866
(240) 645-5101
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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