Individual
GLENN JEFFREY RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
705 DIXIE ST, CARROLLTON, GA 30117-3818
(770) 301-0858
Mailing address
3115 LANCASTER CT APT A, HOMEWOOD, AL 35209-4234
(770) 655-1786
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN230986
GA
Other
Enumeration date
07/13/2021
Last updated
05/24/2023
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