Individual
DR. GLEN P. DATRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D.
Contact information
Practice address
780 S MAIN ST, GREAT BARRINGTON, MA 01230-2148
(413) 528-3606
(413) 528-3607
Mailing address
725 NORTH ST, PITTSFIELD, MA 01201-4109
(413) 447-2752
(413) 496-6836
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
000439
CT
231H00000X
Audiologist
802
MA
231H00000X
Audiologist
856
NY
Other
Enumeration date
04/23/2009
Last updated
02/25/2013
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