| NPI | 1154430411 |
|---|---|
| Former Legal Business Name | GLENN A DAVISON DPM PA |
| Entity Type | Organization |
| Authorized Contact | GLENN A DAVISON President 908-688-5577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NJ 25MD00196300) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NJ 25MD00257000) |
| 213E00000X Podiatrist (Licence: NY N0046131) | |
| 213E00000X Podiatrist (Licence: NY N006069) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-12-07 |