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General NPI Number Information
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NPI Number | 1982630612
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Entity Type | Organization
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Legal Business Name | CYNTHIA L GLASSON INC
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 3003 S BALDWIN RD
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City | ORION
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State | MI
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Zip | 48359-2358
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Country | US
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Telephone | 248-391-9090
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Fax | 248-391-9210
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Provider Business Mailing Address
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Address Line | 3003 S BALDWIN RD
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City | ORION
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State | MI
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Zip | 48359-2358
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Country | US
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Telephone | 248-391-9090
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Fax | 248-391-9210
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Authorized Official
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Title or Position | OWNER
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Name | DR. CYNTHIA L GLASSON
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Credential | D.O.
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Telephone | 248-391-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | CG011459
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License Number State | MI
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