Individual
JONATHON GLENNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4604 OLD LANSING RD, LANSING, MI 48917-4458
(517) 322-9285
Mailing address
4604 OLD LANSING RD, LANSING, MI 48917-4458
(517) 322-9285
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704240473
MI
Other
Enumeration date
03/16/2015
Last updated
03/16/2015
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