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General NPI Number Information
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NPI Number | 1235631623
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Entity Type | Individual
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Provider Name | JOSEPH LEVEN
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Gender | Male
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 03/01/2018
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Provider Practice Location Address
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Address Line | 100 CAMPUS DR
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City | WEATHERFORD
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State | OK
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Zip | 73096-3001
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Country | US
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Telephone | 580-362-6238
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 N 7TH ST APT 14
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City | WEATHERFORD
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State | OK
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Zip | 73096-2897
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Country | US
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Telephone | 580-362-6238
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000030185
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License Number State | OK
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