Individual
TRACY L. CLEVELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1229 E SEMINOLE ST, SPRINGFIELD, MO 65804-2227
(417) 820-5610
(417) 829-5588
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2003010854
MO
Other
Enumeration date
02/06/2007
Last updated
07/22/2008
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