Cheryl Debrough, cosmetology
Prosthetic/Orthotic Supplier in Chesapeake, VA. Individual provider (NPI-1).
NPI number1972237097
StatusActive
Last updated in NPPESJul 13, 2022
Details
- NPI
- 1972237097
- Entity type
- Individual (NPI-1)
- Name
- Cheryl Debrough
- Credential
- cosmetology
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 13, 2022
- Certification date
- Jul 13, 2022
- Last updated
- Jul 13, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 335E00000X | Prosthetic/Orthotic Supplier | 1201082954 | VA | Yes |
| 335E00000X | Prosthetic/Orthotic Supplier | – | – |
Practice location
4107 Portsmouth Blvd Ste 123Chesapeake, VA 23321-2140
Phone 757-606-4999
Mailing address
1208 Gauntlet DrChesapeake, VA 23323-2812
Phone 757-606-4999
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