Individual
MR. JACOB ORITSENEMI UDUAGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5795 PRINCESS ANNE RD, VIRGINIA BEACH, VA 23462-3224
(757) 490-0307
Mailing address
5795 PRINCESS ANNE RD, VIRGINIA BEACH, VA 23462-3224
(757) 490-0307
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202012619
VA
Other
Enumeration date
08/02/2010
Last updated
08/02/2010
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