Individual
GLEN COPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MT
Contact information
Practice address
514 28 1/4 RD UNIT 4, GRAND JUNCTION, CO 81501-4961
(970) 644-5255
Mailing address
2309 1/2 PALACE VERDES DR, GRAND JUNCTION, CO 81507-1356
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0016926
CO
Other
Enumeration date
02/09/2018
Last updated
02/09/2018
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