Individual
DIANE E GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
11141 PARKVIEW PLAZA DR STE 305B, FORT WAYNE, IN 46845-1713
(260) 425-6770
(260) 425-6789
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37000931A
IN
Other
Enumeration date
11/04/2010
Last updated
12/20/2022
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