Individual
CASSANDRA M LATIMER CLEVENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
4024 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1510
(304) 768-7671
(304) 768-6491
Mailing address
612 HIGH ST, SAINT ALBANS, WV 25177-2431
(304) 634-5145
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/29/2008
Last updated
09/29/2008
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