Individual
MR. ANDREW GLAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(561) 506-3107
Mailing address
14507 DRAFT HORSE LN, WELLINGTON, FL 33414-1031
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
15430
FL
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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