Individual
GLENN S HARTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6001
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6001
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MEDO4523
AK
Other
Enumeration date
05/30/2006
Last updated
12/04/2018
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