NPI: 1912212838
Provider Name: GLACIER HEALTHCARE, LLC
Former Legal Business Name: ADVANCED SURGICAL HEALTHCARE, LLC
Classification: Podiatrist - 213EP1101X
Entity Type: Organization
Specialization: Primary Podiatric Medicine
Address:
416 W. 15TH STREET
BUILDING 400, SUITE B
EDMOND, OK
ZIP 73013
Phone: (405) 285-8900
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GLACIER HEALTHCARE, LLC is a primary podiatric medicine podiatrist in Edmond, OK. GLACIER HEALTHCARE, LLC NPI is 1912212838. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Advanced Surgical Healthcare, Llc.
The provider's business location address is:
416 W. 15TH STREET
BUILDING 400, SUITE B
EDMOND, OK
ZIP 73013-688
Phone: (405) 285-8900
Fax: (405) 285-8921
The provider's authorized official is Chad Emery Huffmyer .
The authorized official title is President and has the following contact phone number (405) 285-8900.
The enumeration date for this NPI number is 8/16/2010 and was last updated on 10/27/2011.