Individual
KRISTY LYNN CLEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.P.T.
Contact information
Practice address
626 TRAIL AVE, FREDERICK, MD 21701
(301) 662-1997
Mailing address
197 THOMAS JOHNSON DR STE B, FREDERICK, MD 21702-4314
(301) 662-1997
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
20331
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KBC4H0-62042205
BC/BS
MD
01
—
S404-0021
CAREFIRST BC/BS
MD
Enumeration date
07/14/2006
Last updated
07/26/2018
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