Doctor Name: | GLENN J DECKER |
NPI Number: | 1649451337 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | PT001347 |
Business Practice Address: | 474 Whirlaway Dr Danville, KY - 404229037 |
Business Phone Number: | 8592387650 |
Business Fax Number: | 8592384160 |
Mailing Address: | 474 Whirlaway Dr, DANVILLE |
State: | KY |
Postal Code: | 404229037 |
Phone Number: | 8592387650 |
Fax Number: | 8592384160 |
NPI Enumeration Date: | 11/21/2007 |
NPI Last Update Date: | 11/21/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | PT001347 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |