Individual
ANNETTE GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
32300 S. 625 RD., GROVE, OK 74344
(918) 787-2242
(918) 674-5041
Mailing address
31627 S 619 LN, GROVE, OK 74344-5440
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
73-1022204
OK
Other
Enumeration date
11/15/2023
Last updated
11/15/2023
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