Healthcare Provider Details

I. General information

NPI: 1033048889
Provider Name (Legal Business Name): ANDREW CLEVES
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11525 SNIDER RD
CINCINNATI OH
45249-1218
US

IV. Provider business mailing address

7813 LOCUST LN
CINCINNATI OH
45243-1909
US

V. Phone/Fax

Practice location:
  • Phone: 513-247-0900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT004068
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: