Individual
ETIENNE DIMBECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3671 AUTUMN GLENN CIRCLE, BOTURNSVILLE, MD 20866
(443) 813-8209
Mailing address
PO BOX 1626, COLUMBIA, MD 21044-0626
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA9092
DC
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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