Individual
MICHAEL GLIDEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
161 W VAN ASCHE DR STE 101, FAYETTEVILLE, AR 72703-4999
(479) 966-4491
(479) 966-4311
Mailing address
161 W VAN ASCHE DR STE 101, FAYETTEVILLE, AR 72703-4999
(479) 966-4491
(479) 966-4311
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3875
AR
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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