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General NPI Number Information
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NPI Number | 1992756944
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Entity Type | Individual
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Provider Name | GLENN JAMES LUNDY D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 116 N NORWOOD ST
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City | WALLACE
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State | NC
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Zip | 28466-2730
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Country | US
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Telephone | 910-285-7222
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Fax | 910-285-7229
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Provider Business Mailing Address
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Address Line | 116 N NORWOOD ST STE 6
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City | WALLACE
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State | NC
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Zip | 28466-2730
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Country | US
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Telephone | 910-285-7222
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Fax | 910-285-7229
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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 | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 2913
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License Number State | NC
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