Individual
ROGER GLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2300 S 16TH ST, LINCOLN, NE 68502-3704
(402) 481-5885
(402) 481-4358
Mailing address
2300 S 16TH ST, LINCOLN, NE 68502-3704
(402) 481-5885
(402) 481-4358
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9992
NE
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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