Individual
MR. GLEN NEAL WALDRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
1775 BROWNING WAY, STE 203, ELKO, NV 89801-8335
(775) 738-4494
(775) 777-3192
Mailing address
1775 BROWNING WAY, STE 203, ELKO, NV 89801-8335
(775) 738-4494
(775) 777-3192
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1794
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00819160
RAILROAD MEDICARE PIN
NV
Enumeration date
03/24/2006
Last updated
04/22/2015
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