Individual
DEWAYNE COURTNEY-AMOS JOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
4858 CLIFTON AVE, BALTIMORE, MD 21207-6526
(240) 418-8337
Mailing address
4858 CLIFTON AVE, BALTIMORE, MD 21207-6526
(240) 418-8337
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
L0005539
MD
Other
Enumeration date
12/06/2011
Last updated
12/06/2011
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