Clifford L Kiracofe Pt Pa
LBN: Clifford L Kiracofe Pt Pa
Clifford L Kiracofe Pt Pa is an health care organization with primary practice located at 8836 N Hess St Ste C, Hayden ID 83835-8718. The organization recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as the primary health care specialty.
Clifford L Kiracofe Pt Pa can be contacted via phone (208) 772-6991, or through Kiracofe, Clifford via phone (208) 772-6991.
Contact Information
Primary practice address
8836 N Hess St Ste C
Hayden ID 83835-8718
Phone: (208) 772-6991
Fax: (208) 772-6674
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT1579 | Idaho |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 1620 | Montana |
Profile Details
| NPI number | 1962424952 |
|---|---|
| LBN Legal business name | Clifford L Kiracofe Pt Pa |
| DBA Doing business as | |
| Authorized official | Kiracofe, Clifford |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Jun 12th, 2008 - about 18 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962424952 | NPPES |
| Idaho | MEDICAID | 807136100 |
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