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1457303968
GLEN A MOHAN
FARMINGTON, MO
NPI
1457303968
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MO 142519)
Enumeration Date
2006-05-16
Last Update Date
2017-10-17
Business Address
-- GLEN A MOHAN CFNP
1101 WEBER RD SUITE 302
FARMINGTON, MO 63640-3352
Phone number: 573-756-5787
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Mailing Address
-- GLEN A MOHAN CFNP
501 W PINE ST
FARMINGTON, MO 63640-1439
Phone number: 573-756-8888
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