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Individual

MR. ERIC B GLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMT, MAT

Contact information

Practice address
5257 27TH ST S, FARGO, ND 58104-7780
(701) 809-1179
Mailing address
819 13TH AVE N, FARGO, ND 58102-2628
(701) 809-1179

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1479
ND

Other

Enumeration date
01/31/2020
Last updated
01/31/2020
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