Individual
DESTINY GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4364 SCORPIUS ST, ORLANDO, FL 32816-8035
(406) 823-0171
Mailing address
131 WOODBURY PINES CIR, ORLANDO, FL 32828-9084
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/18/2019
Last updated
03/18/2019
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