Individual
JORDAN TYLER STAIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1602 CENTRAL AVE, SUMMERVILLE, SC 29483-9312
(843) 871-0801
(843) 871-0801
Mailing address
1602 CENTRAL AVE, SUMMERVILLE, SC 29483-9312
(843) 871-0801
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
60140
SC
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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