Individual
DR. GLENN LAURENCE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
196 OLD CONNECTICUT PATH, WAYLAND, MA 01778-3124
(617) 513-1049
(508) 358-7558
Mailing address
196 OLD CONNECTICUT PATH, WAYLAND, MA 01778-3124
(617) 513-1049
(508) 358-7558
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
01061855A
IN
Other
Enumeration date
04/27/2009
Last updated
04/27/2009
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