Individual
JACQUE GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
141 DAISY CT, TROY, AL 36081-1736
(706) 490-7653
Mailing address
141 DAISY CT, TROY, AL 36081-1736
(706) 490-7653
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-127-695
AL
Other
Enumeration date
07/26/2010
Last updated
07/26/2010
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