Individual
AMANDA GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
132 DOUGLAS AVE, HOLLAND, MI 49424-6514
(616) 396-2959
Mailing address
168 E 34TH ST, HOLLAND, MI 49423-7006
(810) 845-8938
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302414823
MI
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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