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NPI Code Detail

MEDICARE: DR. CHARLES RAYMOND GLENN D.C.

MEDICARE:  DR. CHARLES RAYMOND GLENN  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
1111N00000XChiropractorCH0001927FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CH0001927OTHERFLLICENSE NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881663524
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES RAYMOND GLENN D.C.
Provider Business Mailing Address
First Line : 2183 MARINER BLVD
Second Line :
City : SPRING HILL
State : FL
Zip : 34609-3860
Country : US
Telephone Number : 352-686-2554
Fax Number : 352-686-3302
Provider Business Practice Location Address
First Line : 2183 MARINER BLVD
Second Line :
City : SPRING HILL
State : FL
Zip : 34609-3860
Country : US
Telephone Number : 352-686-2554
Fax Number : 352-686-3302
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2006
Last Update Date : 10/27/2016

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Directions to “ DR. CHARLES RAYMOND GLENN D.C.” Practice Location

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