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General NPI Number Information
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NPI Number | 1992918882
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Entity Type | Organization
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Legal Business Name | DR. GLENN, PC
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 11/15/2013
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Provider Practice Location Address
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Address Line | 1780 S BELLAIRE ST SUITE 710
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City | DENVER
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State | CO
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Zip | 80222-4307
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Country | US
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Telephone | 303-300-0424
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24066
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City | DENVER
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State | CO
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Zip | 80224-0066
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Country | US
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Telephone | 303-300-0424
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GLENN HYMAN
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Credential | DC
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Telephone | 303-300-0424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4454
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License Number State | CO
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