Individual
KELLY RAE GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
4150 CLEMENT ST, SAN FRANCISCO, CA 94121-1563
(415) 221-4810
Mailing address
1209 MACARTHUR BLVD, OAKLAND, CA 94610-2846
(510) 421-2056
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
UNKNOWN
CA
Other
Enumeration date
04/08/2022
Last updated
04/08/2022
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