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Individual

MRS. JOHN BRANTLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DR. TAXATION

Contact information

Practice address
1539 SHEFFIELD RD, BALTIMORE, MD 21218-1633
(410) 662-5909
Mailing address
1539 SHEFFIELD RD, BALTIMORE, MD 21218-1633
(410) 662-5909

Taxonomy

Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
390200000X
Student in an Organized Health Care Education/Training Program
03QY679
MD

Other

Enumeration date
10/05/2014
Last updated
10/05/2014
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