Individual
MR. GLENN ALAN STACKHOUSE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
600 MOUNT PLEASANT AVE, SUITE F, DOVER, NJ 07801-1629
(973) 366-4000
(973) 366-4998
Mailing address
115 SAINT MARYS ST, WHARTON, NJ 07885-2020
(973) 442-7937
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00623700
NJ
Other
Enumeration date
06/03/2006
Last updated
07/08/2007
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