Provider Demographics
NPI:1760588495
Name:CLIFFORD, RICK D (DC)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:D
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 1:2759 HIGHWAY 31 W
Mailing Address - Street 2:
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188-5245
Mailing Address - Country:US
Mailing Address - Phone:615-672-3568
Mailing Address - Fax:615-672-5049
Practice Address - Street 1:2759 HIGHWAY 31 W
Practice Address - Street 2:
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188-5245
Practice Address - Country:US
Practice Address - Phone:615-672-3568
Practice Address - Fax:615-672-5049
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001167111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3677777Medicare ID - Type Unspecified