Individual
CHERYL DEBROUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COSMETOLOGY
Contact information
Practice address
4107 PORTSMOUTH BLVD STE 123, CHESAPEAKE, VA 23321-2140
(757) 606-4999
Mailing address
1208 GAUNTLET DR, CHESAPEAKE, VA 23323-2812
(757) 606-4999
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
1201082954
VA
335E00000X
Prosthetic/Orthotic Supplier
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—
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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