Gaffney, Glenn Randolph
Gaffney, Glenn Randolph is an sole proprietor health care provider with primary practice located at 2225 A1A S Suite B-1, St Augustine FL 32080-2916. He recently has only one registered license in Other Service Providers / Contractor, which is considered as his primary health care specialty. Gaffney, Glenn Randolph can be contacted via phone (904) 461-9901.Contact Information
Primary practice address
2225 A1A S Suite B-1
St Augustine FL 32080-2916
Phone: (904) 461-9901
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Contractor | 171W00000X | MA002007 | Florida |
Profile Details
| NPI number | 1871617340 |
|---|---|
| LBN Legal business name | Gaffney, Glenn Randolph |
| Credentials | LMT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 19th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871617340 | NPPES |
| Florida | Other | MA002007 | FL MASSAGE THERAPY LIC # |
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