Individual
TASMAN CLEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
224 S ARTHUR AVE STE 2, POCATELLO, ID 83204-3202
(208) 242-3771
(208) 242-3772
Mailing address
224 S ARTHUR AVE STE 2, POCATELLO, ID 83204-3202
(208) 242-3771
(208) 242-3772
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/13/2017
Last updated
03/13/2017
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