Individual
DR. GLENN SCOTT BREITZIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C., FNP-C
Contact information
Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4294
(417) 761-5000
(417) 761-5011
Mailing address
3401 BERRYWOOD DR STE 300, COLUMBIA, MO 65201-6515
(573) 777-8300
(239) 332-2145
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH0008078
FL
363LF0000X
Family Nurse Practitioner
Primary
2019008101
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
381-400900
—
FL
Enumeration date
12/06/2005
Last updated
04/24/2019
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