Organization
CROWNED GLORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAH KING (MGR)
(407) 952-3702
Entity
Organization
Contact information
Practice address
3437 BOCAGE DR APT 510, ORLANDO, FL 32812-7588
(407) 952-3702
Mailing address
3437 BOCAGE DR APT 510, ORLANDO, FL 32812-7588
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
05/10/2023
Last updated
05/16/2023
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