Kendall Clevenger, PA

NPI #1154654218 in Pine City, Minnesota

Provider Information

NPI Number: 1154654218
Entity Type: Individual
Name: Kendall Clevenger, PA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Sep 8, 2009
Last Updated: Sep 8, 2009

Practice Location

Address: 510 2ND ST SE
City: Pine City
State: Minnesota
ZIP Code: 55063-1706
Phone: (320) 629-6721

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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