Individual
GEORGE FLEMING GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCP
Contact information
Practice address
7220 N LINDBERGH BLVD, HAZELWOOD, MO 63042-2019
(314) 838-8000
(314) 838-8304
Mailing address
1812 PARTRIDGE PL, EDWARDSVILLE, IL 62025-5512
(314) 443-1024
(314) 656-1535
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
125-18
WI
242T00000X
Perfusionist
Primary
199140713
MO
242T00000X
Perfusionist
214.000313
IL
Other
Enumeration date
01/02/2014
Last updated
01/02/2014
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