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Individual

MR. MAURICE JAMAL JEFFERSON SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
542 COLUMBIA ST APT 3, SHREVEPORT, LA 71104-3260
(318) 458-8045
Mailing address
542 COLUMBIA ST APT 3, SHREVEPORT, LA 71104-3260
(318) 458-8045

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
374U00000X
Home Health Aide
Primary

Other

Enumeration date
08/24/2020
Last updated
08/24/2020
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