Provider Demographics
NPI:1720777576
Name:CLIFFORD, JOSEPH RILEY (DPT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:RILEY
Last Name:CLIFFORD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1053 EASTLAND DR
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6747
Mailing Address - Country:US
Mailing Address - Phone:208-736-9011
Mailing Address - Fax:208-934-9014
Practice Address - Street 1:1053 EASTLAND DR
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-6747
Practice Address - Country:US
Practice Address - Phone:208-736-9011
Practice Address - Fax:208-934-9014
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-8438225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist