Individual
JO-DAVY ANDRE JAUREGUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4000 COAST GUARD BLVD, PORTSMOUTH, VA 23703-2135
(757) 483-8596
Mailing address
3977 ORDINARY LOOP, HAYES, VA 23072-2955
(954) 394-1497
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/28/2021
Last updated
09/28/2021
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