Individual
DEFANG ANNU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7955 RIGGS RD, HYATTSVILLE, MD 20783-4565
(281) 818-1189
Mailing address
7955 RIGGS RD, HYATTSVILLE, MD 20783-4565
(281) 818-1189
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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