Individual
GLENN POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2996 CHURCH RD E, SOUTHAVEN, MS 38671-9825
(662) 349-4418
Mailing address
324 NIGHT SAIL DR N, APT. 309, MEMPHIS, TN 38103-0006
(901) 491-8112
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-11914
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07487240
—
MS
Enumeration date
09/27/2011
Last updated
09/27/2011
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