Individual
MRS. BEVERLY KAY GLASURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
820 W RACE ST, KINGSTON, TN 37763-2120
(865) 376-3406
(865) 376-1559
Mailing address
3840 KINGSTON HWY, KINGSTON, TN 37763-5331
(865) 717-1270
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085
TN
Other
Enumeration date
02/01/2007
Last updated
04/22/2009
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