Provider Demographics
NPI:1467690081
Name:GLAZER, JENNIFER (ATC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:GLAZER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 GARBERS CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8421
Mailing Address - Country:US
Mailing Address - Phone:540-421-5730
Mailing Address - Fax:540-433-0286
Practice Address - Street 1:1001 GARBERS CHURCH RD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8421
Practice Address - Country:US
Practice Address - Phone:540-421-5730
Practice Address - Fax:540-433-0286
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260017012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer