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Individual

MR. JOHNNYRHETTE HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1408 FENWOOD AVE, OXON HILL, MD 20745-2303
(240) 409-2135
(301) 749-7163
Mailing address
1408 FENWOOD AVE, OXON HILL, MD 20745-2303
(240) 409-2135
(301) 749-7163

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
44776
MD

Other

Enumeration date
01/06/2015
Last updated
01/06/2015
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