Individual
BRIAN JOSEPH GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1152 W 1140 N, PROVO, UT 84604-3010
(801) 372-7768
Mailing address
1152 W 1140 N, PROVO, UT 84604-3010
(801) 372-7768
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN2285656
MA
Other
Enumeration date
07/16/2013
Last updated
07/16/2013
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