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Individual

JAQUANESE DOUGLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RT(R)

Contact information

Practice address
601 HIGHWAY 6 W, IOWA CITY, IA 52246-2209
(319) 338-0581
Mailing address
505 GARDEN WOOD DR APT 505, ATLANTA, GA 30349-8524
(706) 593-9804

Taxonomy

Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
GA

Other

Enumeration date
12/29/2022
Last updated
12/29/2022
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