Organization
GLAZE CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDAL L MCDANIEL DC (OWNER)
(903) 843-5643
Entity
Organization
Contact information
Practice address
1026 TITUS ST, GILMER, TX 75644-3514
(903) 843-5643
(903) 843-4403
Mailing address
PO BOX 949, GILMER, TX 75644-0949
(903) 843-5643
(903) 843-4403
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0017CC
TX
Other
Enumeration date
06/30/2005
Last updated
04/09/2012
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