Provider Demographics
NPI:1598741159
Name:MCGLINN, JAMES R (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:MCGLINN
Suffix:
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 1:826 HARTFORD AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:WHITE RIVER JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05001-8051
Mailing Address - Country:US
Mailing Address - Phone:802-295-7725
Mailing Address - Fax:802-295-7726
Practice Address - Street 1:826 HARTFORD AVE
Practice Address - Street 2:SUITE C
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001-8051
Practice Address - Country:US
Practice Address - Phone:802-295-7725
Practice Address - Fax:802-295-7726
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT060000638111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTMCVT8760OtherVT BLUE CROSS
VT0502996YVT01OtherANTHEM
VTMCVT8760OtherVT BLUE CROSS
VTMCVT8760OtherVT BLUE CROSS
VTMCVT8760Medicare ID - Type Unspecified