Individual
MARIE L GLORIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
625 W MEMORIAL DR, DALLAS, GA 30132-4120
(678) 903-5103
Mailing address
4235 THAYER DR, POWDER SPRINGS, GA 30127-5651
(404) 985-0242
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
RN217524
GA
Other
Enumeration date
07/30/2020
Last updated
07/30/2020
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