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Individual

SHAWN D JESSUP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1131 RANDOLPH ST, THOMASVILLE, NC 27360-5749
(336) 474-8900
Mailing address
165 HOLLY TREE RD, CLAUDVILLE, VA 24076-3351
(540) 392-8198

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
24156
NC
1835P1200X
Pharmacotherapy Pharmacist
Primary
24156
NC

Other

Enumeration date
10/03/2011
Last updated
08/27/2014
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