Individual
MS. COLETTE TAPANG FUKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2512 QUEENS CHAPEL RD # APPT104, HYATTSVILLE, MD 20782-3650
(918) 814-1997
Mailing address
2512 QUEENS CHAPEL RD # APPT104, HYATTSVILLE, MD 20782-3650
(918) 814-1997
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
251E
MD
Other
Enumeration date
06/16/2012
Last updated
06/16/2012
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