Provider Demographics
NPI:1902642739
Name:GLOWKA, ZACHARY FRANCIS (LMT)
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:FRANCIS
Last Name:GLOWKA
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:ZACH
Other - Middle Name:
Other - Last Name:GLOWKA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:1110 FIDLER LN STE 311
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3481
Mailing Address - Country:US
Mailing Address - Phone:513-633-4292
Mailing Address - Fax:
Practice Address - Street 1:1110 FIDLER LN STE 311
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3481
Practice Address - Country:US
Practice Address - Phone:513-633-4292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019020069225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist