Provider Demographics
NPI:1093942997
Name:GLASS, LEAH ROSE (DO)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:ROSE
Last Name:GLASS
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:300 WINDING WOODS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-4771
Mailing Address - Country:US
Mailing Address - Phone:636-240-0130
Mailing Address - Fax:636-240-6822
Practice Address - Street 1:300 WINDING WOODS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-4771
Practice Address - Country:US
Practice Address - Phone:636-240-0130
Practice Address - Fax:636-240-6822
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2013-06-21
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Provider Licenses
StateLicense IDTaxonomies
MO2009015812207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology