Individual
TAYLOR LEE GLOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
216 HEARTWOOD HL, GREENFIELD, IN 46140-7036
(317) 270-8136
Mailing address
216 HEARTWOOD HL, GREENFIELD, IN 46140-7036
(317) 270-8136
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WMW01317500W
BLUE CROSS BLUE SHIELD
IN
Enumeration date
04/10/2017
Last updated
04/10/2017
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