Individual
JACOB GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
211 W MYRTLE ST STE 104, FORT COLLINS, CO 80521-2917
(813) 391-7730
Mailing address
211 W MYRTLE ST STE 104, FORT COLLINS, CO 80521-2917
(813) 391-7730
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACU.0002339
CO
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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