Individual
KENNETH NYASA BAMBOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4920 NIAGARA RD, STE 318, COLLEGE PARK, MD 20740-1110
(301) 982-6477
(301) 982-6488
Mailing address
4920 NIAGARA RD, STE 318, COLLEGE PARK, MD 20740-1110
(301) 982-6477
(301) 982-6488
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/02/2013
Last updated
04/02/2013
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