DIVINE MOFOR FOMINKA

BOWIE, MD
NPI1841154010
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy374U00000X Home Health Aide
(Licence: DC  HHA200005765)
Enumeration Date2025-12-12
Last Update Date2025-12-12
Business Address
DIVINE MOFOR FOMINKA
908 LAKE FRONT DR
BOWIE, MD 20721-2950
Phone number: 719-725-9850
Mailing Address
DIVINE MOFOR FOMINKA
908 LAKE FRONT DR
BOWIE, MD 20721-2950
Phone number: 719-725-9850
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