# GLEN ALLEN HALVORSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1588754873
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 13342 | NV | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | 13423 | AZ | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | 47769 | CO | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | G75477 | CA | — |

## Other

- **Enumeration date:** 10/15/2006
- **Last updated:** 02/17/2017