Individual
MATT GLAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
205 NW 11TH ST, APT 1, CORVALLIS, OR 97330-6048
(503) 508-5808
Mailing address
205 NW 11TH ST, APT 1, CORVALLIS, OR 97330-6048
(503) 508-5808
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PI-0011449
OR
Other
Enumeration date
05/05/2015
Last updated
05/05/2015
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