Individual
MR. LENNARD JACK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
2041 GEORGIA AVE NW, WASHINGTON, DC 20060-0001
(202) 865-1411
(202) 865-4724
Mailing address
2041 GEORGIA AVE NW, WASHINGTON, DC 20060-0001
(202) 865-1411
(202) 865-4724
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT2120
DC
Other
Enumeration date
10/24/2008
Last updated
10/24/2008
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