| Organization Name: | CYNTHIA L GLASSON INC |
| NPI Number: | 1982630612 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CYNTHIA L GLASSON (OWNER) |
| Mailing Address: | 3003 S Baldwin Rd Orion |
| State: | MI US |
| Postal Code: | 483592358 |
| Phone Number: | 2483919090 |
| Fax Number: | 2483919210 |
| NPI Enumeration Date: | 06/24/2006 |
| NPI Last Update Date: | 01/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | CG011459 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |