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1417021494
GLENN DODGE
ONTARIO, OR
NPI
1417021494
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR 3474)
Enumeration Date
2006-11-20
Last Update Date
2007-07-09
Business Address
MR. GLENN DODGE DPT
49 NW 1ST ST STE 1
ONTARIO, OR 97914-2468
Phone number: 541-889-4550
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Mailing Address
MR. GLENN DODGE DPT
33648 APPLE VALLEY RD
PARMA, ID 83660-6404
Phone number: 208-484-1498
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