Individual
MR. MARTY J GLENN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MS, RD, LD
Contact information
Practice address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
Mailing address
911 N MICHIGAN ST, LAWRENCE, KS 66044-4089
(785) 840-9688
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
832
KS
Other
Enumeration date
06/06/2006
Last updated
07/08/2007
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