Individual
KEENAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
506 58TH ST NE, WASHINGTON, DC 20019-6911
(202) 607-1853
Mailing address
1915 COLEBROOKE DR, TEMPLE HILLS, MD 20748-5605
(301) 532-5784
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
DC
Other
Enumeration date
03/15/2022
Last updated
03/15/2022
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