Glenn K. Roter, Od, A Professional Corporation

NPI 1053612424 - Optometrist - 152W00000X

NPI Details
NPI 1053612424
Enumeration Date 11/16/2010
Last Updated 11/16/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name GLENN K. GLENN
Position PRESIDENT
Phone (702) 368-0092
Fax (702) 368-0097
Practice Location
5200 S FORT APACHE RD
LAS VEGAS NV, 89148-1722, US
Phone (702) 368-0092
Fax (702) 368-0097
Business Location
5200 S FORT APACHE RD
LAS VEGAS NV, 89148-1722, US
Phone (702) 368-0092
Fax (702) 368-0097
Toxanomy
Taxonomy Code 152W00000X
License State Nevada
License Number NV 411
Remove 1053612424 NPI Number
 

According to our database, Glenn K. Roter, Od, A Professional Corporation NPI is 1053612424, taxonomy code is 152W00000X and license number is NV 411, license state is located at Nevada. Glenn K. Roter, Od, A Professional Corporation physically located at 5200 S Fort Apache Rd, Las Vegas NV, 89148-1722. NPI Number 1033115704 has the healthcare provider type.

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1053612424 NPI number is provided on an as is basis without warranty of any kind. 1053612424 is maintained by the National Plan & Provider Enumeration System. The contents of Glenn K. Roter, Od, A Professional Corporation are for informational purposes only.