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Individual

LEJON J JENKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
6555 BULLION AVE, UNIT B, TWENTYNINE PALMS, CA 92277-3293
(619) 517-5945
Mailing address
25878 FRESCA DR, UNIT B, MORENO VALLEY, CA 92553-4951
(619) 517-5945

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
10/23/2007
Last updated
06/17/2009
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