Individual
GLENN M MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
327 MEDICAL PARK DR, BRIDGEPORT, WV 26330-9006
(304) 624-2121
Mailing address
PO BOX 6209, WHEELING, WV 26003-0714
(304) 233-2455
(304) 233-6073
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
74651
WV
Other
Enumeration date
01/23/2009
Last updated
08/16/2011
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