Individual
DWAYNE GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
98 N FRONT ST, NEW BEDFORD, MA 02740-7327
(508) 408-6131
Mailing address
497 BELLEVILLE AVE, NEW BEDFORD, MA 02746-5432
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/03/2014
Last updated
06/05/2014
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