Individual
GLEN CHARLES THAMERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
541 QUANTUM RD NE, RIO RANCHO, NM 87124-4502
(505) 994-9178
(505) 896-0478
Mailing address
PO BOX 368, JEMEZ SPRINGS, NM 87025-0368
(575) 829-4536
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/26/2010
Last updated
07/26/2010
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