Individual
BANKOLE 0 VIATONU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6495 NEW HAMPSHIRE AVE STE A303, HYATTSVILLE, MD 20783-3245
(240) 667-2357
(240) 667-2743
Mailing address
6495 NEW HAMPSHIRE AVE STE A303, HYATTSVILLE, MD 20783-3245
(240) 667-2357
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/06/2023
Last updated
06/06/2023
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