Individual
MR. GLENN A RAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
62 COFFEE DRINKERS RD, DALEVILLE, MS 39326-6019
(601) 480-8972
Mailing address
62 COFFEE DRINKERS RD, DALEVILLE, MS 39326-6019
(601) 480-8972
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0955
MS
Other
Enumeration date
10/24/2018
Last updated
06/20/2019
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