Individual
DR. GLENN PAUL RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4617 MILE STRETCH DR, HOLIDAY, FL 34690-4330
(727) 938-5322
(727) 943-9546
Mailing address
4617 MILE STRETCH DR, HOLIDAY, FL 34690-4330
(727) 938-5322
(727) 943-9546
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0006712
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
380417800
—
FL
Enumeration date
05/17/2006
Last updated
08/16/2010
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