MEDICARE: DR. JAMES PETER GLASGOW D.C.

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	111N00000X	Chiropractor	B696	NV

General Provider Information

NPI Number	:	1689700262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES PETER GLASGOW D.C.

Provider Business Mailing Address
First Line	:	9701 DOUBLE ROCK DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6409
Country	:	US
Telephone Number	:	702-604-8480
Fax Number	:	702-319-4754

Provider Business Practice Location Address
First Line	:	8571 W LAKE MEAD BLVD
Second Line	:	SUITE 120
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-7644
Country	:	US
Telephone Number	:	702-360-5194
Fax Number	:	702-319-4754

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	07/08/2007

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