Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH7829 | FL |
N | 111NN1001X | Nutrition | CH7829 | FL |
N | 111NR0200X | Radiology | CH7829 | FL |
N | 213ER0200X | Radiology | CH7829 | FL |
NPI | 1861406050 |
---|---|
Provider Name | Dr. H. Glenn Corkins |
First Address | Greenacres, FL 33454-2587 |
Second Address | Greenacres, FL 33413-3354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 19/12/2013 |