Individual
MOKOM THADDEUS FON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10010 MARTIN AVE, GLENN DALE, MD 20769-9209
(508) 271-5274
Mailing address
10010 MARTIN AVE, GLENN DALE, MD 20769-9209
(202) 400-7531
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
DC
Other
Enumeration date
08/31/2021
Last updated
05/08/2025
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