Individual
GLENNA MICHELE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 S MAGNOLIA AVE, LANSING, MI 48912-2927
(517) 755-9450
Mailing address
301 S MAGNOLIA AVE, LANSING, MI 48912-2927
(517) 755-9450
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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