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Individual

DR. GLENN D BLANKENHORN III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3300 BAILEY ST NW, STE 104, MASSILLON, OH 44646-3613
(330) 837-3823
(330) 837-8313
Mailing address
3300 BAILEY ST NW, STE 104, MASSILLON, OH 44646-3613
(330) 837-3823
(330) 837-8313

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
34003712
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0586852
OH
Enumeration date
06/09/2005
Last updated
12/17/2007
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