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Individual
GARY R GLISSON
Active
Individual
GARY R GLISSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R PH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7023
NC
211D00000X
Podiatric Assistant
20733
NC
332B00000X
Durable Medical Equipment & Medical Supplies
20733
NC
335E00000X
Prosthetic/Orthotic Supplier
20733
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20733
BCP-BOARD OF CERTIFICATION IN PEDORTHICS
NC
05
—
7795227
—
NC
Enumeration date
08/11/2005
Last updated
03/12/2009
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