Individual
MR. MICHAEL JERRY MISSOURI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
431 54TH ST SE APT A1, WASHINGTON, DC 20019-6573
(202) 200-6558
Mailing address
816 SOUTHERN AVE SE APT 301, WASHINGTON, DC 20032-3497
(202) 802-3962
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
01/12/2024
Last updated
01/12/2024
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