Organization
CLEAR GLASS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MALCOLM BRIAN GLASS APN (ADVANCE PRACTICE NURSE)
(615) 596-7654
Entity
Organization
Contact information
Practice address
510 HOSPITAL DR, SUITE 304, MADISON, TN 37115-5033
(615) 596-7654
(615) 712-7639
Mailing address
121 TYNE BAY DR, HENDERSONVILLE, TN 37075-4034
(615) 596-7654
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
13198
TN
Other
Enumeration date
12/08/2011
Last updated
05/17/2013
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