Individual
CHARLES CHUKS ETOLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6111 KOVACH CT, ELLICOTT CITY, MD 21043-6936
(703) 898-7628
Mailing address
6111 KOVACH CT, ELLICOTT CITY, MD 21043-6936
(703) 898-7628
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/12/2020
Last updated
07/12/2020
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