Individual
DR. GLEN SCHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
19150 ACORN RD, SUITE 103, FORT MYERS, FL 33912-3657
(239) 267-3133
(239) 267-8032
Mailing address
19150 ACORN RD, SUITE 103, FORT MYERS, FL 33912-3657
(239) 267-3133
(239) 267-8032
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH0004195
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350007311
RR MEDICARE
—
05
—
3806162-00
—
FL
01
—
440696
PCA
—
01
—
593466707
CAC
—
Enumeration date
10/12/2005
Last updated
04/01/2008
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