Individual
MR. JUSTIN MATTHEW GLAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-C
Contact information
Practice address
1107 MEMORIAL DR STE G2, DALTON, GA 30720-8662
(706) 529-3245
(706) 272-6077
Mailing address
1107 MEMORIAL DR STE G2, DALTON, GA 30720-8662
(706) 529-3245
(706) 272-6077
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN-NP268132
GA
363LF0000X
Family Nurse Practitioner
Primary
RN268132
GA
Other
Enumeration date
07/18/2022
Last updated
05/07/2026
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