Individual
GLEN D BABCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
89288 KNIGHT RD, ELMIRA, OR 97437-9799
(541) 935-3803
Mailing address
89288 KNIGHT RD, ELMIRA, OR 97437-9799
(541) 935-3803
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
—
OR
Other
Enumeration date
12/26/2006
Last updated
07/08/2007
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