Individual
ANTONIO ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2401 BRYAN PL SE, WASHINGTON, DC 20020-4433
(202) 562-6364
Mailing address
2401 BRYAN PL SE, WASHINGTON, DC 20020-4433
(202) 562-6364
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
09/24/2019
Last updated
09/24/2019
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