Provider Demographics
NPI:1043791411
Name:DOMANGO TRAINING INC.
Entity Type:Organization
Organization Name:DOMANGO TRAINING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PERSONAL TRAINER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANDA
Authorized Official - Middle Name:DOMANGO
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED PERSONAL T
Authorized Official - Phone:504-975-0815
Mailing Address - Street 1:523 RIVER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-5207
Mailing Address - Country:US
Mailing Address - Phone:504-975-0815
Mailing Address - Fax:
Practice Address - Street 1:523 RIVER OAKS DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-5207
Practice Address - Country:US
Practice Address - Phone:504-975-0815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation