Individual
LEROY DONOVAN BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 SPEIGHT ST, HAVELOCK, NC 28532-2426
(252) 241-9783
Mailing address
110 SPEIGHT ST, HAVELOCK, NC 28532-2426
(252) 241-9783
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
NC
172A00000X
Driver
Primary
4512701
NC
172A00000X
Driver
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2362659
DRIVER
NC
Enumeration date
03/04/2022
Last updated
03/25/2022
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