Individual
JORDAN GOFORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
978 N MAIN ST, MONTICELLO, KY 42633-1500
(606) 348-8478
Mailing address
406 BOGLE ST, SOMERSET, KY 42503-2840
(317) 667-2465
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
021449
KY
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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