Condon, Glenn Allan

Condon, Glenn Allan is an individual health care provider with primary practice located at 1200 N Beaver St , Flagstaff AZ 86001-3118. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as his primary health care specialty. Condon, Glenn Allan can be contacted via phone (928) 773-2054.

Contact Information

Primary practice address
1200 N Beaver St Flagstaff AZ 86001-3118
Phone: (928) 773-2054
Fax: (928) 773-2286
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X 1581 Arizona

Profile Details

NPI number 1902957699
LBN Legal business name Condon, Glenn Allan
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902957699 NPPES
Arizona Other 001581 PT LICENSE NUMBER

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