Javon Mytira Willis

NPI #1861076200 in Lutherville, Maryland

Provider Information

NPI Number: 1861076200
Entity Type: Individual
Name: Javon Mytira Willis
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: May 11, 2021
Last Updated: May 11, 2021

Practice Location

Address: 2525 POT SPRING RD
City: Lutherville
State: Maryland
ZIP Code: 21093-2778
Phone: (410) 561-0200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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