Individual
MR. MARK J GLACCUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
415 GORDON AVENUE, THOMASVILLE, GA 31792
(229) 226-3101
(229) 225-1745
Mailing address
415 GORDON AVENUE, THOMASVILLE, GA 31792
(229) 226-3101
(229) 225-1745
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR002714
GA
Other
Enumeration date
03/25/2008
Last updated
03/25/2008
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