Individual
FNU FONTA LIEMBO FONTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6603 MANTON WAY, LANHAM, MD 20706-2490
(703) 944-2201
Mailing address
6603 MANTON WAY, LANHAM, MD 20706-2490
(703) 944-2201
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA13733
DC
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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