Individual
GLENN GHOLSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1801 HICKMAN RD, DES MOINES, IA 50314-1548
(515) 282-2319
(515) 282-3234
Mailing address
1801 HICKMAN RD, DES MOINES, IA 50314-1548
(515) 282-2319
(515) 282-3234
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R7951
IA
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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