Individual
JESSE GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 PEARTREE LN, ROARING SPRING, PA 16673-8720
(814) 571-4594
Mailing address
111 PEARTREE LN, ROARING SPRING, PA 16673-8720
(814) 571-4594
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT002198A
PA
Other
Enumeration date
04/22/2016
Last updated
04/22/2016
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