Individual
GLENDA MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
17 AFHEA LN, GILBERTSVILLE, KY 42044-8806
(270) 362-5004
(270) 362-5008
Mailing address
PO BOX 430, GILBERTSVILLE, KY 42044-0430
(270) 362-5004
(270) 362-5008
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-003256
KY
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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