Clifford L Kiracofe Pt PA

NPI #1962424952 in Hayden, Idaho

Provider Information

NPI Number
1962424952
Entity Type
Organization
Organization Name
Clifford L Kiracofe Pt PA
Primary Specialty
Physical Therapist
Enumeration Date
Jul 25, 2006
Last Updated
Jun 12, 2008

Practice Location

Address
8836 N HESS ST
Address 2
STE C
City
Hayden
State
Idaho
ZIP Code
83835-8718
Phone
(208) 772-6991

Authorized Official

Name
CLIFFORD KIRACOFE
Title
OWNER
Phone
(208) 772-6991

Specialties & Taxonomy Codes

Specialty
Physical Therapist

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