Provider Demographics
NPI:1972680387
Name:GLOGOWER, MITCHELL G (D C)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:G
Last Name:GLOGOWER
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14100 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:JUNO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-1404
Mailing Address - Country:US
Mailing Address - Phone:561-262-9072
Mailing Address - Fax:561-626-6733
Practice Address - Street 1:14100 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-1404
Practice Address - Country:US
Practice Address - Phone:561-262-9072
Practice Address - Fax:561-626-6733
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004923111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70636Medicare ID - Type Unspecified