Provider Demographics
NPI:1871610196
Name:CLEVELAND, PAUL R (PT)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:R
Last Name:CLEVELAND
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:720 COOL SPRINGS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2626
Mailing Address - Country:US
Mailing Address - Phone:615-778-4066
Mailing Address - Fax:615-778-9114
Practice Address - Street 1:109 MINUS AVENUE SUITE C-10
Practice Address - Street 2:GARDEN GROVE SHOPPING CENTER
Practice Address - City:GARDEN CITY
Practice Address - State:GA
Practice Address - Zip Code:31408
Practice Address - Country:US
Practice Address - Phone:615-778-4066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPT001090225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist