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NPI Code Detail

MEDICARE: ANDREW JOEL CLIFFORD PT

MEDICARE:   ANDREW JOEL CLIFFORD  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist11-04717KS

General Provider Information

NPI Number : 1629415468
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW JOEL CLIFFORD PT
Provider Business Mailing Address
First Line : 1400 S KANSAS AVE STE 1200
Second Line :
City : NEWTON
State : KS
Zip : 67114-5305
Country : US
Telephone Number : 316-677-8877
Fax Number : 316-333-2407
Provider Business Practice Location Address
First Line : 234 W GREENWAY ST
Second Line :
City : DERBY
State : KS
Zip : 67037-2641
Country : US
Telephone Number : 316-788-6734
Fax Number : 316-788-4529
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2013
Last Update Date : 02/23/2026

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Directions to “ ANDREW JOEL CLIFFORD PT” Practice Location

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