Individual
MAKINNA CLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
617 E RIVERSIDE DR STE 104, ST GEORGE, UT 84790-8720
(801) 656-2059
(435) 656-3059
Mailing address
5914 S CHALLENGER WAY, ST GEORGE, UT 84790-1778
(801) 907-0312
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
6543993-1717
UT
Other
Enumeration date
01/19/2021
Last updated
01/19/2021
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