Individual
MR. KEVIN A GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MMSC, PA
Contact information
Practice address
1133 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5085
(404) 367-3014
Mailing address
1133 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5085
(404) 367-3014
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/12/2013
Last updated
04/11/2017
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