Individual
JEREMY L CLEVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
2420 NICOLET DR, UW-GREEN BAY, GREEN BAY, WI 54311-7003
(920) 465-2138
(920) 465-2652
Mailing address
2420 NICOLET DR, UW-GREEN BAY, GREEN BAY, WI 54311-7003
(920) 465-2138
(920) 465-2652
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
644-039
WI
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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