Individual
GLENN KLUCKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
740 HIGH ST, SUITE 4001, WILLIAMSPORT, PA 17701-3102
(570) 321-2345
Mailing address
1201 GRAMPIAN BLVD, SUITE 4001, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
OS018778
PA
208000000X
Pediatrics Physician
OS018778
PA
Other
Enumeration date
04/03/2013
Last updated
11/06/2023
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