Individual
NATHANIEL W GLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1741 E EDEN PL, ST FRANCIS, WI 53235-3644
(920) 858-9978
Mailing address
1741 E EDEN PL, ST FRANCIS, WI 53235-3644
(920) 858-9978
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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