Individual
MR. WILLIE J MYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
KT
Contact information
Practice address
3900 LOCH RAVEN BLVD, BALTIMORE, MD 21218-2108
(410) 605-7631
Mailing address
1401 KITMORE RD, BALTIMORE, MD 21239-3410
(410) 433-4659
Taxonomy
Speciality
Code
Description
License number
State
226300000X
Kinesiotherapist
Primary
—
—
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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