Individual
JORDAN ANDREW IBARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-3690
Mailing address
604 PINE BND, CHESAPEAKE, VA 23320-6736
(706) 814-0105
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
04/18/2025
Last updated
04/18/2025
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