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Individual

DR. BRYAN H. GLENN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
700 W KINGSHIGHWAY STE A, PARAGOULD, AR 72450-5929
(870) 239-6004
(870) 972-8603
Mailing address
700 W KINGSHIGHWAY STE A, PARAGOULD, AR 72450-5929
(870) 239-6004
(870) 972-8603

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
AR175
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
132181717
AR
Enumeration date
11/03/2006
Last updated
10/24/2008
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