Individual
MR. GLENN DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
198 S OREGON STREET, ONTARIO, OR 97914-2808
(541) 889-4550
(541) 889-4628
Mailing address
198 S OREGON STREET, ONTARIO, OR 97914-2808
(541) 889-4550
(541) 889-4628
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3474
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500628426
—
OR
Enumeration date
11/20/2006
Last updated
04/27/2026
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