Individual
JOVANNY N/A AVILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 PARK CENTER CT STE 102, OWINGS MILLS, MD 21117-5613
(410) 377-8900
Mailing address
10301 GRAND CENTRAL AVE APT 529, OWINGS MILLS, MD 21117-4075
(845) 545-0622
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A5725
MD
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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