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Glen Willis, LPN
NPI 1326585902 · on the registry since 2017 · sole proprietor
Practice
- Address
- 1807 Rugby Pl Apt B
Coram, NY 11727 - Phone
- (631) 627-9455
Registry record
- Primary taxonomy
- 164W00000X
164W00000X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2017-01-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York