Individual
MR. DAVID ALEXANDER GLENN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
5501 MARVIN SHIELDS BLVD, GULFPORT, MS 39501-9007
(228) 822-5061
Mailing address
5501 MARVIN SHIELDS BLVD, GULFPORT, MS 39501-9007
(228) 822-5061
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/12/2012
Last updated
04/12/2012
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