Individual
JACOB CLEVENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1710 KY-121 SUITE K, MURRAY, KY 42071
(270) 767-6397
Mailing address
2110 VINTAGE HILLS DR APT A, MURRAY, KY 42071-4780
(931) 619-1564
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
280029
KY
Other
Enumeration date
10/11/2019
Last updated
01/09/2023
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