Individual
MARK GLASSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7719 BRIDLEWOOD RD, CALEDONIA, IL 61011-9011
(815) 222-9242
Mailing address
7719 BRIDLEWOOD RD, CALEDONIA, IL 61011-9011
(815) 222-9242
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
041249330
IL
Other
Enumeration date
02/14/2024
Last updated
02/14/2024
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