Organization
THERAPEUTIC INJECTION SERVICE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY GLASGOW CRNA (OWNER)
(785) 856-8472
Entity
Organization
Contact information
Practice address
1201 WAKARUSA DRIVE, SUITE A2, LAWRENCE, KS 66049-3889
(785) 856-8472
Mailing address
PO BOX 388, NEWTON, KS 67114-0388
(316) 281-3700
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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