Provider Demographics
NPI:1669948436
Name:STRICKLAND, DAJUAN J
Entity type:Individual
Prefix:
First Name:DAJUAN
Middle Name:J
Last Name:STRICKLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:PAGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29728-1925
Mailing Address - Country:US
Mailing Address - Phone:704-777-9438
Mailing Address - Fax:803-696-4227
Practice Address - Street 1:122 N PEARL ST
Practice Address - Street 2:
Practice Address - City:PAGELAND
Practice Address - State:SC
Practice Address - Zip Code:29728-1925
Practice Address - Country:US
Practice Address - Phone:704-777-9438
Practice Address - Fax:803-696-4227
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi