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Individual

JAVON MYTIRA WILLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2525 POT SPRING RD, LUTHERVILLE, MD 21093-2778
(410) 561-0200
Mailing address
1501 RALWORTH RD, BALTIMORE, MD 21218-2231
(410) 306-5485

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A5478
MD

Other

Enumeration date
05/11/2021
Last updated
05/11/2021
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