Individual
DEMETRIUS WILLIAM JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3921 S ST SE, WASHINGTON, DC 20020-1062
(202) 468-5522
Mailing address
2320 24TH ST SE, WASHINGTON, DC 20020-3402
(202) 491-4420
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/21/2021
Last updated
11/21/2021
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