Provider Demographics
NPI:1306203807
Name:GLASER, CRYSTAL (DC)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:
Last Name:GLASER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7831 S HIGHLANDPOINT WAY
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84081-6049
Mailing Address - Country:US
Mailing Address - Phone:435-562-1513
Mailing Address - Fax:435-562-1545
Practice Address - Street 1:5481 W 7800 S STE 110
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84081-6027
Practice Address - Country:US
Practice Address - Phone:435-562-1513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01647111N00000X
UT9545633-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor