Individual
BRYAN DEVAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 N CHARLES ST STE 400, BALTIMORE, MD 21201-5594
(410) 375-0032
Mailing address
5108 PLYMOUTH RD, BALTIMORE, MD 21214-2151
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
R02802
MD
Other
Enumeration date
04/08/2019
Last updated
04/08/2019
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