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1275680027
GLEN C BANNISTER
MONTGOMERY, AL
NPI
1275680027
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: AL 125)
Enumeration Date
2007-01-04
Last Update Date
2007-07-09
Business Address
-- GLEN C BANNISTER Ed.D.
4216 LOMAC ST
MONTGOMERY, AL 36106-2817
Phone number: 334-277-5956
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Mailing Address
-- GLEN C BANNISTER Ed.D.
4216 LOMAC ST
MONTGOMERY, AL 36106-2817
Phone number: 334-277-5956
Copy
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