Doctor Name: | MRS. CAROL R GLENN |
NPI Number: | 1467609297 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.P.T. |
License Number: | 5501010567 |
Business Practice Address: | 25700 Pontiac Trl South Lyon, MI - 481788047 |
Business Phone Number: | 2484462801 |
Business Fax Number: | 2484462802 |
Mailing Address: | 790 Remington Blvd, BOLINGBROOK |
State: | IL |
Postal Code: | 604404909 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/22/2008 |
NPI Last Update Date: | 03/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501010567 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |