Organization
GLAM CHIX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN RODRIGUEZ (OWNER/CEO)
(804) 484-0292
Entity
Organization
Contact information
Practice address
7424 BROOK RD STE D, RICHMOND, VA 23227-1817
(804) 484-0292
Mailing address
11908 LUSBYS LN, BRANDYWINE, MD 20613-7680
(804) 484-0292
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
1204017518
VA
Other
Enumeration date
02/06/2018
Last updated
12/21/2018
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