Individual
JAN S GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-A
Contact information
Practice address
514 E WOOLBRIGHT RD, BOYNTON BEACH, FL 33435-6033
(561) 434-9944
Mailing address
149 PLANTATION RIDGE DR STE 140, MOORESVILLE, NC 28117-9175
(704) 230-0007
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
1601000072
MI
231H00000X
Audiologist
A01525
OH
231H00000X
Audiologist
Primary
AY1405
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
804700455
—
MI
05
—
904547880
—
MI
Enumeration date
06/06/2006
Last updated
01/31/2020
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