Individual
TANJA COURTER BRANDOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1153 CAMPGROUND RD, ELIZABETH CITY, NC 27909-7529
(518) 921-8832
Mailing address
1153 CAMPGROUND RD, ELIZABETH CITY, NC 27909-7529
(518) 321-8832
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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