Individual
GREG GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
2600 CAMPUS DR, SUITE A, LAFAYETTE, CO 80026-3357
(303) 673-1900
(303) 673-1915
Mailing address
2600 CAMPUS DR, SUITE A, LAFAYETTE, CO 80026-3357
(303) 673-1900
(303) 673-1915
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2290
CO
363A00000X
Physician Assistant
PA2005-0016
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
76459551
—
CO
Enumeration date
03/16/2006
Last updated
10/05/2012
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