Individual
TRACI LEE GLYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
237 BIRCH DR, MUSKEGON, MI 49445-2213
(231) 744-2086
Mailing address
237 BIRCH DR, MUSKEGON, MI 49445-2213
(231) 744-2086
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703098560
MI
Other
Enumeration date
04/02/2009
Last updated
04/02/2009
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