Individual
JORDAN GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
5401 W INTEGRITY WAY, APPLETON, WI 54913-8602
(920) 815-4510
Mailing address
3143 HIDDEN POND RD, SUAMICO, WI 54313-8369
(920) 619-2672
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18841
WI
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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