Glen P Revere, R.D., C.D.E.

NPI #1477628980 in Parker, Arizona

Provider Information

NPI Number
1477628980
Entity Type
Individual
Name
Glen P Revere, R.D., C.D.E.
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dietitian, Registered
Credential
R.D., C.D.E.
Enumeration Date
Nov 21, 2006
Last Updated
Jul 8, 2007

Practice Location

Address
12033 AGENCY RD
City
Parker
State
Arizona
ZIP Code
85344-7718
Phone
(928) 669-2137

Specialties & Taxonomy Codes

Specialty
Dietitian, Registered

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