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Individual

DENVER LEE GLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
1200 FERGUSON ST, NACOGDOCHES, TX 75961-4068
(936) 564-7359
Mailing address
16725 US HIGHWAY 259, NACOGDOCHES, TX 75965-8096

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1207626
TX

Other

Enumeration date
11/21/2011
Last updated
07/09/2013
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