Individual
MS. SHANNON E GLASOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
210 NE MAIN ST, SIMPSONVILLE, SC 29681-2318
(086) 477-0363
Mailing address
655H FAIRVIEW RD # 181, SIMPSONVILLE, SC 29680-6706
(864) 770-3638
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
SC
Other
Enumeration date
01/31/2017
Last updated
02/26/2021
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