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Individual

CLARENCE BUREN GLOVER JR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
708 S 8TH ST, GRIFFIN, GA 30224-4827
(770) 228-5402
(770) 412-6917
Mailing address
708 S 8TH ST, GRIFFIN, GA 30224-4827
(770) 228-5402
(770) 412-6917

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002296
GA

Other

Enumeration date
08/10/2005
Last updated
07/08/2007
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