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Individual

DR. DUSTIN RAY GLASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
22600-F LAMBERT ST., STE 1202, LAKE FOREST, CA 92630
(949) 273-5935
(949) 273-5936
Mailing address
22600-F LAMBERT ST., STE 1202, LAKE FOREST, CA 92630
(949) 273-5935
(949) 273-5936

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
DC28953
CA

Other

Enumeration date
05/24/2007
Last updated
07/08/2007
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