Individual
MR. GLEN DEPINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
ST . BERNARD'S RD, GLADSTONE, NJ 07934-0604
(908) 234-1611
Mailing address
PO BOX 604, ST BERNARD'S RD, GLADSTONE, NJ 07934-0604
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00074500
NJ
Other
Enumeration date
03/20/2007
Last updated
07/26/2010
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