Individual
MODEBOLA SANNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7609 FONTAINEBLEAU DR APT 2213, NEW CARROLLTON, MD 20784-3822
(240) 491-2741
Mailing address
7609 FONTAINEBLEAU DR APT 2213, NEW CARROLLTON, MD 20784-3822
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
—
—
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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