Individual
GLENN HOWARD HERMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3416 VIRGINIA AVE, SUITE #3, COLLINSVILLE, VA 24078-2240
(276) 747-4488
(276) 647-7569
Mailing address
3416 VIRGINIA AVE, SUITE #3, COLLINSVILLE, VA 24078-2240
(276) 747-4488
(276) 647-7569
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000497
VA
152WC0802X
Corneal and Contact Management Optometrist
0618000497
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009231854
—
VA
01
—
040437
BLUE CROSS BLUE SHIELD
VA
01
—
450168
COBINED INSURANCE CO OF A
VA
01
—
541741479
ACCORDIA NATIONAL
VA
05
—
541741479
—
VA
01
—
5674
VISION WITH B/C B/S
VA
01
—
910899
COLE
VA
01
—
9615238
CIGNA HEALTHCARE
VA
Enumeration date
06/19/2006
Last updated
11/04/2016
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