Individual
COLLEEN ELIZABETH GLISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
845 N NEW BALLAS CT, SUITE 200, SAINT LOUIS, MO 63141-7134
(314) 983-4700
(314) 692-9862
Mailing address
12639 OLD TESSON RD, SUITE 115, SAINT LOUIS, MO 63128-2786
(314) 849-0311
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2010010436
MO
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
2010010436
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811181308
—
MO
Enumeration date
08/28/2007
Last updated
07/19/2019
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