Organization
LAURIE GLANZ
Active
Other names
disorders of the foot
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE BETH GLANZ DPM (LAURIE B GLANZ DPM)
(586) 463-1555
Entity
Organization
Contact information
Practice address
35 CHURCH ST, MOUNT CLEMENS, MI 48043-2331
(586) 463-1555
(586) 463-7550
Mailing address
35 CHURCH ST, MOUNT CLEMENS, MI 48043-2331
(586) 463-1555
(586) 463-7550
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
LG001020
MI
335E00000X
Prosthetic/Orthotic Supplier
LG001020
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1397171
—
MI
01
—
145899
SELECTCARE PROVIDER
MI
01
—
480002510
RAILROAD MEDICARE
MI
01
—
4855050200
BCBS PIN
MA
01
—
ADR5
NEIC SITE ID
MI
01
—
LG001020
LICENSE NUMBER
MI
01
—
P79090
BLUE CARE NETWORK
MI
Enumeration date
12/05/2007
Last updated
05/21/2012
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