Individual
GLENN LYTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3801 W UTICA ST, BROKEN ARROW, OK 74011-1365
(918) 286-1920
(918) 286-1920
Mailing address
3801 W UTICA ST, BROKEN ARROW, OK 74011-1365
(918) 286-1920
(918) 286-1920
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16019
OK
Other
Enumeration date
12/29/2005
Last updated
10/09/2014
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