Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CH8643 | FL |
N | 111NR0400X | Rehabilitation Chiropractor | CHRI007588 | GA |
NPI | 1033242102 |
---|---|
Provider Name | Dr. Mauricio Glaser |
First Address | Atlanta, GA 31141-0188 |
Second Address | Atlanta, GA 30341-4409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |