Individual
JENNIFER GLANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
950 S MAIN ST STE 3, CELINA, OH 45822-2467
(419) 586-5170
(419) 586-5177
Mailing address
1920 CLINTON AVE, SAINT CLAIR, MI 48079-5238
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
5101013945
MI
207VB0002X
Obesity Medicine (Obstetrics & Gynecology) Physician
Primary
34008744
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659334290
—
MI
01
—
700G410560
BLUE CROSS
MI
Enumeration date
04/06/2006
Last updated
09/23/2016
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