| Doctor Name: | GLEN DAVID MCLEOD |
| NPI Number: | 1457507881 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 5783 |
| Business Practice Address: | 1450 Crystal Lake Rd Aspen Sports Medicine Institute Aspen, CO - 816112255 |
| Business Phone Number: | 9709258940 |
| Business Fax Number: | 9709259543 |
| Mailing Address: | Po Box 11977, ASPEN |
| State: | CO |
| Postal Code: | 816129390 |
| Phone Number: | 9703198111 |
| Fax Number: | |
| NPI Enumeration Date: | 08/18/2008 |
| NPI Last Update Date: | 08/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251S0007X |
| License Number: | 5783 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Sports |
| Taxonomy Definition: | |