GLENN R PROVDO

TOMS RIVER, NJ
NPI1467574814
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy213E00000X Podiatrist
(Licence: NJ  25MD00149000)
Enumeration Date2007-04-05
Last Update Date2007-07-08
Business Address
Dr. GLENN R PROVDO D.P.M.
2446 CHURCH RD SUITE 2C
TOMS RIVER, NJ 08753-8182
Phone number: 732-255-8637
Mailing Address
Dr. GLENN R PROVDO D.P.M.
2446 CHURCH RD SUITE 2C
TOMS RIVER, NJ 08753-8182
Phone number: 732-255-8637
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