Individual
IRA LEE GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2008 S MAPLE ST, LITTLE ROCK, AR 72204-4033
(501) 258-9566
Mailing address
2601 FAIR PARK BLVD, LITTLE ROCK, AR 72204-5149
(318) 638-8139
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
000309182
AR
Other
Enumeration date
03/31/2009
Last updated
03/31/2009
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