Organization
SUSAN M GLAD, OD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN MARIE GLAD O.D. (PRESIDENT)
(503) 434-1140
Entity
Organization
Contact information
Practice address
2375 N HIGHWAY 99W, MCMINNVILLE, OR 97128-9201
(503) 434-1140
Mailing address
140 SW POPLAR ST, YAMHILL, OR 97148-8046
(503) 434-1140
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2319ATI
OR
Other
Enumeration date
10/13/2010
Last updated
10/13/2010
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