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Individual

GWEN CLEAVES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1000 MORRIS AVE, UNION, NJ 07083-7133
(908) 737-0658
Mailing address
1000 MORRIS AVE, UNION, NJ 07083-7133
(908) 737-0658

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00010400
NJ

Other

Enumeration date
02/09/2017
Last updated
02/09/2017
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