Glendale Healthcare, LLC
NPI #1063188167 in Hattiesburg, Mississippi
Provider Information
- NPI Number
- 1063188167
- Entity Type
- Organization
- Organization Name
- Glendale Healthcare, LLC
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Aug 18, 2021
- Last Updated
- Aug 18, 2021
Practice Location
- Address
- 2503 GLENDALE AVE
- City
- Hattiesburg
- State
- Mississippi
- ZIP Code
- 39401-1073
- Phone
- (601) 582-5805
Authorized Official
- Name
- AKWASI WAYNE AMPONSAH, DC
- Title
- CEO
- Phone
- (314) 435-6386
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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