Provider Demographics
NPI:1295048767
Name:GLYNN, DANIEL WILLIAM
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:WILLIAM
Last Name:GLYNN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1348
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-1348
Mailing Address - Country:US
Mailing Address - Phone:781-294-4270
Mailing Address - Fax:781-293-6307
Practice Address - Street 1:4 MOUNTAIN AVE.
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359
Practice Address - Country:US
Practice Address - Phone:781-294-4270
Practice Address - Fax:781-293-6307
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist