NPI 1790204063

Glenn Beall, CPO

Practitioner Prosthetist Oakland, NJ

Practice location

Address: 48 Hiawatha Blvd, Oakland, NJ 07436-2919
Phone: (619) 867-6094

Registered specialties

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X Licence 45PO00017000 (NJ)

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Registry record

NPI: 1790204063
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Sep 2017
Record last updated: 18 Sep 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.