Individual
CHARLES C GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3550 S 4TH ST STE 250, LEAVENWORTH, KS 66048-5061
(913) 565-2569
(913) 565-2571
Mailing address
2200 SW 6TH AVE STE 104, TOPEKA, KS 66606-1707
(785) 354-8518
(785) 354-1255
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01742
KS
363A00000X
Physician Assistant
2015022139
MO
Other
Enumeration date
09/30/2014
Last updated
07/08/2021
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