Provider Demographics
NPI:1235349879
Name:GLASS, JANE (DO)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:
Last Name:GLASS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:46 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-1341
Mailing Address - Country:US
Mailing Address - Phone:207-838-0049
Mailing Address - Fax:207-780-6320
Practice Address - Street 1:50 SEWALL STREET
Practice Address - Street 2:SUITE 301
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102
Practice Address - Country:US
Practice Address - Phone:207-780-6631
Practice Address - Fax:207-780-6320
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME12492081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine