Individual
GLEN KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
BLDG H. 2005 KNIGHT LANE, NAVY MEDICINE SUPPORT COMMAND, JACKSONVILLE, FL 32212-0140
(843) 228-7068
Mailing address
31 PARK CIR, BLUFFTON, SC 29910-8011
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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