Individual
MR. JASON A. GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1965 S FREMONT AVE STE 130, SPRINGFIELD, MO 65804-2252
(417) 820-5150
(417) 820-5155
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2003025739
MO
Other
Enumeration date
07/18/2006
Last updated
07/15/2008
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