Provider Demographics
NPI:1205986981
Name:PARTRIDGE, GLENN ARNOLD (DC)
Entity type:Individual
Prefix:DR
First Name:GLENN
Middle Name:ARNOLD
Last Name:PARTRIDGE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 W CLINTON ST
Mailing Address - Street 2:PO BOX 108
Mailing Address - City:DURAND
Mailing Address - State:MI
Mailing Address - Zip Code:48429-1158
Mailing Address - Country:US
Mailing Address - Phone:989-288-5351
Mailing Address - Fax:989-288-5254
Practice Address - Street 1:102 W CLINTON ST
Practice Address - Street 2:
Practice Address - City:DURAND
Practice Address - State:MI
Practice Address - Zip Code:48429-1158
Practice Address - Country:US
Practice Address - Phone:989-288-5351
Practice Address - Fax:989-288-5254
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor