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Individual

LEONARD C. GLYNN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
5612 WHITESVILLE RD STE B, COLUMBUS, GA 31904
(706) 322-2223
Mailing address
5612 WHITESVILLE RD STE B, COLUMBUS, GA 31904-9031
(706) 322-2223
(706) 324-5233

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002654
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100001537B
GA
Enumeration date
07/24/2006
Last updated
08/26/2019
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