Individual
JAQUAN JIMMY HARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 E LAUREL RD STE B, STRATFORD, NJ 08084-1324
(609) 304-0991
Mailing address
101 E LAUREL RD STE B, STRATFORD, NJ 08084-1324
(609) 304-0991
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/28/2026
Last updated
04/28/2026
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