NPI 1629212501

Benicia Elaine Cleveland, MEDLATATC

Practitioner Athletic Trainer Winston-Salem, NC

Practice location

Address: 1250 S Martin Luther King Jr. Drive Winston-Salem State University, Winston-Salem, NC 27107
Phone: (336) 750-2597
Fax: (336) 750-8880

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 1231 (NC)

Other Specialist/Technologist providers in North Carolina →

Registry record

NPI: 1629212501
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Apr 2009
Record last updated: 13 Sep 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.