Organization
COURTNEY GLENN DPM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY GLENN DPM (OWNER)
(814) 758-8425
Entity
Organization
Contact information
Practice address
1515 RIVER PL STE 370, BRASELTON, GA 30517-5605
(770) 648-5040
(706) 780-5366
Mailing address
1515 RIVER PL STE 370, BRASELTON, GA 30517-5605
(770) 648-5040
(706) 780-5366
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
POD001277
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831454750
PERSONAL NPI NUMBER
—
Enumeration date
07/22/2015
Last updated
12/29/2025
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