Individual
MR. GLYNN JORDAN BOGARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
9929 S PADRE ISLAND DR STE 113, CORPUS CHRISTI, TX 78418-5148
(361) 937-5508
Mailing address
538 DEL MAR BLVD, CORPUS CHRISTI, TX 78404-2906
(361) 815-0421
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
122096
TX
Other
Enumeration date
07/03/2015
Last updated
07/03/2015
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