Individual
CARLY CLEVENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14379 BLACK FARM DR, NOBLESVILLE, IN 46060-7261
(219) 776-5668
Mailing address
14379 BLACK FARM DR, NOBLESVILLE, IN 46060-7261
(219) 776-5668
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
296696
CA
Other
Enumeration date
06/28/2019
Last updated
10/27/2024
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