| Doctor Name: | PATRICK GLASCOCK |
| NPI Number: | 1316360985 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | R.T. (R) |
| License Number: | 914469 |
| Business Practice Address: | 5260 W Hayden Ave Rathdrum, ID - 838589467 |
| Business Phone Number: | 2086605943 |
| Business Fax Number: | |
| Mailing Address: | 1920 W Canfield Ave, COEUR D ALENE |
| State: | ID |
| Postal Code: | 838150413 |
| Phone Number: | 2086401693 |
| Fax Number: | |
| NPI Enumeration Date: | 01/31/2014 |
| NPI Last Update Date: | 01/31/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471C3402X |
| License Number: | 914469 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Radiography |
| Taxonomy Definition: | |