Provider Information for 1407490287
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Mrs. DEVANN SHEA BROWN
Sex: Female
NPI: 1407490287
Last Updated: 2020-08-02
Certification Date: 2020-08-02
Certification Date: 2020-08-02
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1407490287 | ||||||||
| Enumeration Date | 2019-11-04 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2714 GRANDIN RD SW ROANOKE, VA 24015-3925 United States Phone: 540-682-6493 | Fax: | ||||||||
| Primary Practice Address | 180 AMT TECH DR STE A4 ROCKY MOUNT, VA 24151-6735 United States Phone: 540-855-7186 | Fax: | ||||||||
| Secondary Practice Address(es) | 2714 GRANDIN RD SW | ||||||||
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