Provider Demographics
NPI:1497840649
Name:GLOVER, WILLIAM CHRISTOPHER (ATC/L)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CHRISTOPHER
Last Name:GLOVER
Suffix:
Gender:M
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 BELL RD
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:TN
Mailing Address - Zip Code:38237
Mailing Address - Country:US
Mailing Address - Phone:731-588-0511
Mailing Address - Fax:
Practice Address - Street 1:1722 E REELFOOT AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-6050
Practice Address - Country:US
Practice Address - Phone:731-885-1077
Practice Address - Fax:731-885-4728
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAT4372255A2300X
KYAT3912255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer