Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 4006 | AZ |
NPI | 1518979467 |
---|---|
Provider Name | Dr. William Glenn Lay |
First Address | Maricopa, AZ 85239-6920 |
Second Address | Maricopa, AZ 85239-6920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 29/12/2008 |