Individual
DR. GLENN K. ROTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5200 S FORT APACHE RD, LAS VEGAS, NV 89148-1722
(702) 368-0092
(702) 368-0097
Mailing address
5200 S FORT APACHE RD, LAS VEGAS, NV 89148-1722
(702) 368-0092
(702) 368-0097
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
411
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100504878
—
NV
Enumeration date
10/28/2006
Last updated
11/16/2010
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