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1356029003
BONIFACE LEBOG
BOWIE, MD
NPI
1356029003
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
251S00000X
Enumeration Date
2023-07-11
Last Update Date
2023-07-21
Business Address
BONIFACE LEBOG
2508 BROOKE GROVE RD
BOWIE, MD 20721-1885
Phone number: 202-894-6811
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Mailing Address
BONIFACE LEBOG
2508 BROOKE GROVE RD
BOWIE, MD 20721-1885
Phone number: 240-886-7978
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