Lucinda Glass, DC

Individual provider Active NPI Chiropractor · Mancos, CO

NPI 1780685016 · NPPES record last updated May 17, 2011

Key facts

NPI
1780685016
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
3351 (CO)
Practice address
164 E Frontage St
Mancos, CO 81328
Phone
(970) 533-1024
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
3351COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Essence of Healing, PC Chiropractor Past
since Sep 21, 2010
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3351 CO Yes

Addresses

Primary practice location

164 E Frontage St
Mancos, CO 81328

Mailing address

PO Box 688
Mancos, CO 81328-0688
Phone (970) 533-1024

Other providers in Mancos, CO

All providers in Mancos, CO · Chiropractor in Colorado

Sources for this page

Verify at the official NPI Registry.