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MR. GLENN COTTRILL

>> Durable Medical Equipment & Medical Supplies >> Suppliers

Registrant NPI Number: 1396063772

Individual Registrant:
MR. GLENN  COTTRILL 
Gender: M
Sole Proprietor

Location and contact information for practice:
930 MAR WALT DR STE D  FT. WALTON BEACH, FL 32547 US
Tel: 850-863-5959  Fax: 850-863-5977

Contact information for business:
930 MAR WALT DR STE D  FT. WALTON BEACH, FL 32547 US
Tel: 850-863-5959  Fax: 850-863-5977

Registration Information:
NPI: 1396063772
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
FLPOR31

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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