MEDICARE: MISS MAGGIE P GLAROS DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT020028	OH

General Provider Information

NPI Number	:	1528795911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MAGGIE P GLAROS DPT

Provider Business Mailing Address
First Line	:	1265 BOARDMAN CANFIELD RD
Second Line	:
City	:	BOARDMAN
State	:	OH
Zip	:	44512-4010
Country	:	US
Telephone Number	:	330-758-9400
Fax Number	:	330-726-8676

Provider Business Practice Location Address
First Line	:	1265 BOARDMAN CANFIELD RD
Second Line	:
City	:	BOARDMAN
State	:	OH
Zip	:	44512-4010
Country	:	US
Telephone Number	:	330-758-9400
Fax Number	:	330-726-8676

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2022
Last Update Date	:	08/04/2022

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