Individual
JORDAN TRUSTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5165 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 414-7662
Mailing address
5165 MCCARTY LN, LAFAYETTE, IN 47905-8764
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
67021924A
IN
Other
Enumeration date
05/30/2019
Last updated
10/14/2019
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