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1578501094
GLENN JOSEPH LYSACK
PENSACOLA, FL
NPI
1578501094
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: FL PA3242)
Enumeration Date
2006-06-04
Last Update Date
2018-01-16
Business Address
GLENN JOSEPH LYSACK PA
5151 N 9TH AVE
PENSACOLA, FL 32504-8721
Phone number: 850-416-7000
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Mailing Address
GLENN JOSEPH LYSACK PA
PO BOX 2699
PENSACOLA, FL 32513-2699
Phone number: 850-416-7000
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