Individual
BLAKE ADAM GLYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
BLANCHFIELD ARMY COMMUNITY HOSPITAL, 650 JOEL DRIVE, FORT CAMPBELL, KY 42223
(270) 798-8400
Mailing address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/25/2018
Last updated
12/13/2018
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