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NPI 1295002756

NPI 1295002756 : MR. GLENN SALTS JR. : JUPITER, FL

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General NPI Number Information
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    NPI Number           |    1295002756
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    Entity Type          |    Individual 
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    Provider Name        |    MR. GLENN SALTS JR.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/28/2011
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    Last Update Date     |    11/28/2011
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Provider Practice Location Address
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    Address Line         |    1448 N.U.S.HWY.1 
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    City                 |    JUPITER
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    State                |    FL
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    Zip                  |    33469-3235
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    Country              |    US
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    Telephone            |    561-744-3887
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    Fax                  |    561-744-9401
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Provider Business Mailing Address
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    Address Line         |    1448 N.U.S.HWY.1 
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    City                 |    JUPITER
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    State                |    FL
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    Zip                  |    33469-3235
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    Country              |    US
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    Telephone            |    561-744-3887
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    Fax                  |    561-744-9401
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    PS17223
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    License Number State |    FL
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