Provider Demographics
NPI:1366509366
Name:OZALAN, GLENN THOMAS (NMD)
Entity type:Individual
Prefix:DR
First Name:GLENN
Middle Name:THOMAS
Last Name:OZALAN
Suffix:
Gender:M
Credentials:NMD
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Mailing Address - Street 1:2138 W MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-7770
Mailing Address - Country:US
Mailing Address - Phone:602-380-5518
Mailing Address - Fax:623-298-5644
Practice Address - Street 1:9360 E RAINTREE DR
Practice Address - Street 2:TIME4HEALTH STE #101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2099
Practice Address - Country:US
Practice Address - Phone:602-380-5518
Practice Address - Fax:623-298-5644
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ78-324175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath