Individual
GLENN M THORESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 CHAUTAUQUA BLVD, VALLEY CITY, ND 58072-3145
(701) 845-6000
(701) 845-6150
Mailing address
520 CHAUTAUQUA BLVD, VALLEY CITY, ND 58072-3145
(701) 845-6000
(701) 845-6150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3031
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12569
—
ND
05
—
553597200
—
MN
Enumeration date
07/26/2006
Last updated
09/10/2008
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