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Organization
GLENVILLE STATE UNIVERSITY
Active
Organization
GLENVILLE STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT WALTERS (HEAD ATHLETIC TRAINER)
(304) 462-6223
Entity
Organization
Contact information
Practice address
200 HIGH ST, GLENVILLE, WV 26351-1200
(304) 462-6223
Mailing address
PO BOX 819020, DALLAS, TX 75381-9020
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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