Individual
GLENN BECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
470 BACON RD, PAINESVILLE, OH 44077-4769
(440) 354-9900
(440) 354-9910
Mailing address
PO BOX 74928, CLEVELAND, OH 44194-1011
(216) 383-6776
(216) 383-6745
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34006109B
OH
Other
Enumeration date
10/02/2006
Last updated
12/19/2007
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