Individual
ZACHARY DEAN GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
500 E COLLEGE ST, MARSHALL, MO 65340-3109
(660) 831-4195
Mailing address
201 W HALL ST, PILOT GROVE, MO 65276-1170
(660) 537-6883
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2016031650
MO
Other
Enumeration date
03/12/2018
Last updated
03/12/2018
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