Individual
MR. GLENN M STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
420 OWEN DR, FAYETTEVILLE, NC 28304-3430
(910) 484-1210
(910) 484-1347
Mailing address
7169 GOLDSBORO RD, WADE, NC 28395-8959
(910) 717-1714
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102083
NC
Other
Enumeration date
10/04/2005
Last updated
02/20/2017
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