Individual
PATRICK GLASCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.T. (R)
Contact information
Practice address
5260 W HAYDEN AVE, RATHDRUM, ID 83858-9467
(208) 660-5943
Mailing address
1920 W CANFIELD AVE, COEUR D ALENE, ID 83815-0413
(208) 640-1693
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
914469
OR
2471C3402X
Radiography Radiologic Technologist
Primary
RT 60406832
WA
Other
Enumeration date
01/31/2014
Last updated
01/31/2014
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