Individual
MRS. ELIZABETH GOODWIN CLEAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D
Contact information
Practice address
7989 US HIGHWAY 64, MEMPHIS, TN 38133-4007
(901) 384-0263
Mailing address
4527 MAYFIELD GLEN CV APT 104, COLLIERVILLE, TN 38017-2033
(901) 581-7834
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
43510
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106957967
DRIVERS LICENSE
TN
Enumeration date
07/24/2019
Last updated
07/24/2019
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