Zachary Dean Glenn, ATC
Individual provider Active NPI Athletic Trainer · Marshall, MO
NPI 1144723644 · NPPES record last updated Mar 12, 2018
Key facts
- NPI
- 1144723644
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 2016031650 (MO)
- Practice address
- 500 E College St
Marshall, MO 65340-3109 - Phone
- (660) 831-4195
- NPI assigned
- Mar 12, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016031650 | MO | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2016031650 | MO | Yes |
Addresses
Primary practice location
500 E College St
Marshall, MO 65340-3109
Mailing address
201 W Hall St
Pilot Grove, MO 65276-1170
Phone (660) 537-6883
Other providers in Marshall, MO
- First Choice Supported Living
- Fitzgibbon Health Services
- Miranda Fitzpatrick
- Megan Rae Forrer
- Lindsey Gerfaud
- Avery Goehman
- Golden Oaks Assisted Living I LLC
- Golden Oaks, LLC
- Ann Marie Gray
- Shelby Lee Gregory
All providers in Marshall, MO · Athletic Trainer in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.