Individual
KIM GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1435 G ST, SPRINGFIELD, OR 97477-4113
(541) 735-9420
Mailing address
1435 G ST, SPRINGFIELD, OR 97477-4113
(541) 935-9420
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-714
ID
Other
Enumeration date
01/24/2008
Last updated
03/24/2026
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