Organization
CHIC GLAM SLAY
Active
Parent organization
N/A
Other names
BOUGIE CLIQUE MEDICAL PROSTHESIS
Organization subpart
Yes
Provider details
NPI number
Legal business name
N/A
Authorized official
MONICA RODRIQUEZ RN,COSMETOLOGIST (CEO)
(323) 875-3099
Entity
Organization
Contact information
Practice address
17820 FIRTREE CT, CARSON, CA 90746-1696
(323) 875-3099
Mailing address
860 E CARSON ST STE 114, CARSON, CA 90745-7948
(323) 870-1413
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/10/2024
Last updated
04/10/2024
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