Individual
MRS. TARA BETH MCCLOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
12544 US ROUTE 60, ASHLAND, KY 41102-9687
(606) 475-0232
(606) 475-0254
Mailing address
84 WOODCREST RD, GRAYSON, KY 41143-1933
(606) 475-1016
(606) 474-0648
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
012986
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012986
PHARMACIST ID
KY
Enumeration date
03/28/2007
Last updated
07/08/2007
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