Individual
DR. JONATHAN W. GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
448 5TH AVE SW, MAGEE, MS 39111-3960
(601) 849-4070
(601) 849-4055
Mailing address
PO BOX 969, MAGEE, MS 39111-0969
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1089
MS
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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