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Individual

MR. GLENN WAYNE BRIETZKE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, RD, LD, CNSC

Contact information

Practice address
3851 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4501
(830) 609-8185
Mailing address
3851 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4501

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT82958
TX

Other

Enumeration date
07/21/2016
Last updated
08/04/2023
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