Individual
JORDAN FUGITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
69 DOGWOOD AVE, ATTN: PHARMACY, JOHNSON CITY, TN 37604
(423) 926-1171
Mailing address
1003 JOHNSON AVE, JOHNSON CITY, TN 37604-5311
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD13066
AR
Other
Enumeration date
09/16/2015
Last updated
09/16/2015
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