Individual
ANTONIO JEFFRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4660 MARTIN LUTHER KING JR AVE SW, WASHINGTON, DC 20032-4933
(202) 318-0179
Mailing address
4660 MARTIN LUTHER KING JR AVE SW, WASHINGTON, DC 20032-4933
(202) 318-0179
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/31/2023
Last updated
03/31/2023
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