Provdo, Glenn R
Provdo, Glenn R is an sole proprietor health care provider with primary practice located at 2446 Church Rd Suite 2C, Toms River NJ 08753-8182. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Provdo, Glenn R can be contacted via phone (732) 255-8637.Contact Information
Primary practice address
2446 Church Rd Suite 2C
Toms River NJ 08753-8182
Phone: (732) 255-8637
Fax: (609) 698-6813
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 25MD00149000 | New Jersey |
Profile Details
NPI number | 1467574814 |
---|---|
LBN Legal business name | Provdo, Glenn R |
Credentials | Doctor of Podiatric Medicine (DPM) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Apr 5th, 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.
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