Individual
JAWUANTAE RIDGEWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
2501 PARKERS LN, ALEXANDRIA, VA 22306-3209
(931) 302-0971
Mailing address
2501 PARKERS LN, ALEXANDRIA, VA 22306-3209
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
0136000871
VA
Other
Enumeration date
09/09/2025
Last updated
10/24/2025
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