| Doctor Name: | COURTNEY LYNN GLENN |
| NPI Number: | 1831454750 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPM |
| License Number: | POD001277 |
| Business Practice Address: | 1574 Friendship Rd 200 Hoschton, GA - 305484146 |
| Business Phone Number: | 7706485040 |
| Business Fax Number: | 7708486062 |
| Mailing Address: | 1574 Friendship Rd 200, HOSCHTON |
| State: | GA |
| Postal Code: | 305484146 |
| Phone Number: | 7706485040 |
| Fax Number: | 7708486062 |
| NPI Enumeration Date: | 07/06/2012 |
| NPI Last Update Date: | 08/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | POD001277 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |