MEDICARE: CAROLINE CLIFT

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
1	225700000X	Massage Therapist	7501010086	MI

General Provider Information

NPI Number	:	1225563620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE CLIFT

Provider Business Mailing Address
First Line	:	156 SAND CREEK HWY
Second Line	:	APT O
City	:	ADRIAN
State	:	MI
Zip	:	49221-9170
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	216 E CHICAGO BLVD
Second Line	:
City	:	TECUMSEH
State	:	MI
Zip	:	49286-1549
Country	:	US
Telephone Number	:	517-902-9657
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2017
Last Update Date	:	04/24/2017

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Directions to “ CAROLINE CLIFT ” Practice Location

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