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Organization

GLENN FAMILY MEDICINE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TRAVIS WAGNER GLENN MD (MEMBER)
(808) 244-5366
Entity
Organization

Contact information

Practice address
85 MAUI LANI PKWY, WAILUKU, HI 96793-2416
(330) 904-9354
Mailing address
85 MAUI LANI PKWY, WAILUKU, HI 96793-2416
(808) 244-5366

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
03/24/2021
Last updated
12/09/2022
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