Individual
JANINE GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
340 WOODLAND CT, CORAM, NY 11727-3625
(631) 839-3297
Mailing address
340 WOODLAND CT, CORAM, NY 11727-3625
(631) 839-3297
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002741
NY
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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