Individual
GLENNTEAYA M BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERTIFICATE
Contact information
Practice address
413 N LAUREL ST, BRIDGETON, NJ 08302-1524
(856) 405-7328
Mailing address
413 N LAUREL ST, BRIDGETON, NJ 08302-1524
(856) 405-7328
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
03/25/2013
Last updated
03/25/2013
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