Individual
TERESA CLEAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
804 RIVER MIST DR, JONESBORO, GA 30238-5748
(770) 985-4257
(770) 985-4258
Mailing address
804 RIVER MIST DR, JONESBORO, GA 30238-5748
(770) 985-4257
(770) 985-4258
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
03012108
GA
Other
Enumeration date
01/07/2009
Last updated
01/07/2009
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