Individual
RUSSELL WAYNE GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Mailing address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 391-9572
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/10/2021
Last updated
06/10/2021
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