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Individual

GLENN MARK LIBMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
12449 83RD PL NE, KIRKLAND, WA 98034-2570
(425) 820-2810
Mailing address
12449 83RD PL NE, KIRKLAND, WA 98034-2570
(425) 820-2810

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7490
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7490
PHYSICAL THERAPY LICENSE
WA
Enumeration date
12/26/2006
Last updated
07/08/2007
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