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Individual

GLENN STEWART HERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
331 CHURCH ST, NAUGATUCK, CT 06770-2806
(203) 729-4047
(203) 723-9103
Mailing address
331 CHURCH ST, NAUGATUCK, CT 06770-2806
(203) 729-4047
(203) 723-9103

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
708
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004092508
CT
01
050000708CT01
ANTHEM BLUE CROSS/BLUE SH
CT
Enumeration date
08/31/2006
Last updated
07/08/2007
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