Individual
NELVIS FON MOKOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9792 WHISKEY RUN, LAUREL, MD 20723-1434
(240) 906-0295
Mailing address
9792 WHISKEY RUN, LAUREL, MD 20723-1434
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA12924
DC
Other
Enumeration date
07/10/2017
Last updated
02/16/2018
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