Individual
DR. GLENN DAVID CARLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3237 RIVERSIDE DR, GREEN BAY, WI 54301-1643
(920) 336-2020
(920) 336-2709
Mailing address
3237 RIVERSIDE DR, GREEN BAY, WI 54301-1643
(920) 336-2020
(920) 336-2709
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2070
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00270020
RAILROAD MEDICARE
—
Enumeration date
06/01/2006
Last updated
04/24/2008
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