Individual
JORDAN IAN SHENK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6767 E BROADWAY BLVD, TUCSON, AZ 85710-4016
(520) 290-0958
Mailing address
6767 E BROADWAY BLVD, TUCSON, AZ 85710-2806
(520) 290-0958
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
36399
SC
183500000X
Pharmacist
Primary
S021728
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S021728
PHARMACIST
AZ
Enumeration date
08/19/2015
Last updated
01/15/2016
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