| Doctor Name: | GLENN R CARLSON |
| NPI Number: | 1477640050 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSPT, DPT |
| License Number: | 004764 |
| Business Practice Address: | 210 Walmart Dr Ste 100 Benchmark Physical Therapy Soddy Daisy, TN - 373795022 |
| Business Phone Number: | 4233329490 |
| Business Fax Number: | |
| Mailing Address: | 6697 Hickory Brook Rd, CHATTANOOGA |
| State: | TN |
| Postal Code: | 374211780 |
| Phone Number: | 4237184584 |
| Fax Number: | |
| NPI Enumeration Date: | 10/06/2006 |
| NPI Last Update Date: | 06/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 004764 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |