Organization
THE GLAM PASS INC.
Active
Other names
Simply Wiggin' It
Organization subpart
No
Provider details
NPI number
Authorized official
KYLA R ROGERS (OWNER)
(305) 494-6608
Entity
Organization
Contact information
Practice address
9455 103RD ST APT 613, JACKSONVILLE, FL 32210-9273
(305) 494-6608
Mailing address
9455 103RD ST APT 613, JACKSONVILLE, FL 32210-9273
(305) 494-6608
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
11/13/2020
Last updated
11/13/2020
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