Individual
ASIA GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
410 S AVALON ST, VFW DRIVE, WEST MEMPHIS, AR 72301-4183
(870) 394-9577
(870) 394-9575
Mailing address
703 CALVIN AVERY DR, SUITE A, WEST MEMPHIS, AR 72301-6501
(870) 732-1878
(870) 702-7111
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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