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Individual

MS. MODESTER MAKUKULS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
480 W SOUTH ST, FREDERICK, MD 21701-6381
(240) 765-8963
Mailing address
480 W SOUTH ST, FREDERICK, MD 21701-6381
(240) 765-8963

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Enumeration date
05/29/2012
Last updated
05/29/2012
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