Individual
MARY JOHNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5130 DURHAM RD E, COLUMBIA, MD 21044-1423
(410) 772-5399
Mailing address
5130 DURHAM RD E, COLUMBIA, MD 21044-1423
(410) 772-5399
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
03/23/2017
Last updated
03/23/2017
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