Individual
MR. TIMOTHY M. GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2535 HUALAPAI MOUNTAIN RD., SUITE C, KINGMAN, AZ 86401
(928) 692-8300
(928) 692-1323
Mailing address
2535 HUALAPAI MOUNTAIN RD., SUITE C, KINGMAN, AZ 86401
(928) 692-8300
(928) 692-1323
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5210
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350038374
RAILROAD MEDICARE
AZ
01
—
404963
APIPA
AZ
01
—
44-00109
UHC
AZ
01
—
AZ0243170
BLUE CROSS
AZ
Enumeration date
07/06/2006
Last updated
01/08/2014
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