Individual
BOONEGROSS FORKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13832 CASTLE BLVD, APT 104, SILVER SPRING, MD 20904-7368
(202) 558-0278
Mailing address
13832 CASTLE BLVD, APT 104, SILVER SPRING, MD 20904-7368
(202) 558-0278
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/30/2012
Last updated
04/30/2012
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