Individual
JORDAN GREGORY SHEPPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1249 15TH ST, HUNTINGTON, WV 25701-3662
(304) 691-1420
Mailing address
1249 15TH ST, HUNTINGTON, WV 25701-3662
(304) 691-1420
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0011746
WV
Other
Enumeration date
09/29/2019
Last updated
05/04/2020
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