Individual
DR. GLENN R. EZELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2201 1ST CAPITOL DR STE 101, SAINT CHARLES, MO 63301-5805
(636) 485-6661
(636) 916-0668
Mailing address
2201 1ST CAPITOL DR STE 101, SAINT CHARLES, MO 63301-5805
(636) 485-6661
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2013000467
MO
Other
Enumeration date
01/09/2013
Last updated
04/29/2020
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