Individual
MR. NATHAN OWEN GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
951 N WASHINGTON AVE BLDG 4, TITUSVILLE, FL 32796-2194
(321) 268-6111
Mailing address
2605 COLUMBIA BLVD APT 1406, TITUSVILLE, FL 32780-7821
(828) 558-1388
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
20768
FL
Other
Enumeration date
07/31/2012
Last updated
12/09/2024
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