Individual
CONSTANCE N GLENN-MADDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 MARIETTA BLVD, ATLANTA, GA 30318
(470) 723-2943
Mailing address
1392 BUCKINGHAM CT, HAMPTON, GA 30228-3254
(470) 723-2943
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CO119189
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO119189
SPECIALIST
GA
Enumeration date
03/30/2021
Last updated
03/30/2021
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