Individual
JAVONTA DAMAR YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4363 MARTIN LUTHER KING JR AVE SW, WASHINGTON, DC 20032-1247
(202) 808-5025
Mailing address
4363 MARTIN LUTHER KING JR AVE SW, WASHINGTON, DC 20032-1247
(202) 808-5025
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
T62240626
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70138499
—
DC
Enumeration date
04/18/2013
Last updated
04/18/2013
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