Individual
GODLOVE LONGLA CHOFONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3805 ERNST DR, BOWIE, MD 20716-3208
(240) 486-2147
Mailing address
3805 ERNST DR, BOWIE, MD 20716-3208
(240) 486-2147
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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