Provider Demographics
NPI:1710043773
Name:CLIFFORD, JOSEPH B (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:CLIFFORD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-3340
Mailing Address - Country:US
Mailing Address - Phone:931-528-7374
Mailing Address - Fax:931-528-7374
Practice Address - Street 1:404 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3340
Practice Address - Country:US
Practice Address - Phone:931-528-7374
Practice Address - Fax:931-528-7374
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000284111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0020629OtherBLUECROSS BLUESHIELD
TN3672268Medicare ID - Type Unspecified