Individual
BENJAMIN CLEVELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
500 W UNIVERSITY ST, SHAWNEE, OK 74804-2522
(405) 585-5351
Mailing address
43777 HUNTERS HILL DR, SHAWNEE, OK 74801-8938
(251) 623-0135
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1261
TN
2255A2300X
Athletic Trainer
Primary
911
OK
Other
Enumeration date
07/31/2014
Last updated
05/02/2016
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