Individual
JORDAN ASHLEY SAMAHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13500 HIGHWAY 90, BOUTTE, LA 70039-3500
(985) 331-1886
Mailing address
4921 PRETTY LAKE AVE APT 219, NORFOLK, VA 23518-2028
(985) 212-4410
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202218534
VA
183500000X
Pharmacist
Primary
PST.023269
LA
Other
Enumeration date
10/29/2019
Last updated
02/06/2020
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