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Individual

MS. LISA KELLI GLENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
6450 SW ARCHER RD, 210, GAINESVILLE, FL 32608-6133
(352) 378-7517
Mailing address
6450 SW ARCHER RD, 210, GAINESVILLE, FL 32608-6133
(352) 378-7517

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA18140
FL

Other

Enumeration date
11/22/2016
Last updated
11/22/2016
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