Individual
GLEN E WALDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO LPO
Contact information
Practice address
2865 ZELDA ROAD, MONTGOMERY, AL 36106
(334) 395-8118
(334) 395-8119
Mailing address
126 SYCAMORE DRIVE, PRATTVILLE, AL 36066
(334) 730-4835
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
183
AL
174400000X
Specialist
Primary
POR151
FL
Other
Enumeration date
02/12/2007
Last updated
02/04/2008
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