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1619341856
JEFFREY CLEVENGER
LAFAYETTE, IN
NPI
1619341856
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: IN 36000065A)
Enumeration Date
2015-11-28
Last Update Date
2015-11-28
Business Address
JEFFREY CLEVENGER M.S.
1801 S 18TH ST
LAFAYETTE, IN 47905-2011
Phone number: 765-772-4711
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Mailing Address
JEFFREY CLEVENGER M.S.
2043 E 430 S
LAFAYETTE, IN 47909-8105
Phone number: 765-772-4711
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