Organization
GLAM QUEEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LENA AGNES SHIELDS (OWNER)
(478) 391-3220
Entity
Organization
Contact information
Practice address
13 PEACH ST, BUTLER, GA 31006-5338
(478) 391-3220
Mailing address
13 PEACH ST, BUTLER, GA 31006-5338
(478) 391-3220
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
02/22/2023
Last updated
02/22/2023
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