Provider Demographics
NPI:1467482117
Name:GLOVER, ROBERT H JR (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:GLOVER
Suffix:JR
Gender:M
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:PO BOX 17926
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92623-7926
Mailing Address - Country:US
Mailing Address - Phone:949-293-3809
Mailing Address - Fax:
Practice Address - Street 1:24552 RAYMOND WAY # 1
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-9000
Practice Address - Country:US
Practice Address - Phone:949-293-3809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 27573111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor