Provider Demographics
NPI:1134313653
Name:MCCANTS, GLEN AUTHOR (RPSGT)
Entity type:Individual
Prefix:MR
First Name:GLEN
Middle Name:AUTHOR
Last Name:MCCANTS
Suffix:
Gender:M
Credentials:RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 PINEY GROVE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-3748
Mailing Address - Country:US
Mailing Address - Phone:803-772-2571
Mailing Address - Fax:
Practice Address - Street 1:310 PINEY GROVE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-3748
Practice Address - Country:US
Practice Address - Phone:803-772-2571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16932278C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedCritical Care