Individual
LAURA KOZOYED JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
231 E 39TH ST, NORFOLK, VA 23504-1003
(757) 613-1583
Mailing address
231 E 39TH ST, NORFOLK, VA 23504-1003
(757) 613-1583
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202009102
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202009102
PHARMACY LICENSE
VA
Enumeration date
02/14/2007
Last updated
11/15/2017
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