Individual
MRS. LISA MARIE GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 MANZANITA ST, CENTRAL POINT, OR 97502-3064
(541) 494-6611
Mailing address
931 CHEVY WAY, MEDFORD, OR 97504-4127
(541) 690-3555
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/17/2013
Last updated
12/26/2019
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