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Dominique Chanel Brown

NPI Registration Record

Provider / OrganizationNPIDate Certified
DOMINIQUE CHANEL BROWN11549293212020-10-11
Entity TypeIndividual
Provider Name Dominique Chanel Brown
Practice Office Address15501 WESTON PKWY STE 130
CARY, NC US
Practice Office Telephone8182416780
Mailing Address1055 E COLORADO BLVD STE 560
PASADENA, CA 911062380 US
Business Telephone8182416780
HPT Codes
CodeLicense NoState
106S00000X PRIMARY
OPI Codes

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