Individual
CLOVIS TEGABONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9120 CRANDALL RD, LANHAM, MD 20706-1929
(307) 851-9357
Mailing address
9120 CRANDALL RD, LANHAM, MD 20706-1929
(307) 851-9357
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
01/24/2022
Last updated
08/07/2024
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