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General NPI Number Information
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NPI Number | 1740345024
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Entity Type | Individual
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Provider Name | JANET MARIE CLIFTON LAT ATC CSCS
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Gender | Female
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 8227 NORTHWEST BLVD SUITE 160 ST VINCENT SPORTS MEDICINE CENTER
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City | INDIANAPOLIS
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State | IN
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Zip | 46278
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Country | US
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Telephone | 317-415-5747
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Fax | 317-322-4287
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Provider Business Mailing Address
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Address Line | 1520 EAST 44TH STREET
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City | ANDERSON
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State | IN
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Zip | 46013
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Country | US
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Telephone | 765-649-2928
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Fax | 317-322-4287
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 36001139A
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License Number State | IN
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