MEDICARE: KAREN A TIFTICK 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
1	225100000X	Physical Therapist	PT11885	CA

General Provider Information

NPI Number	:	1386760577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN A TIFTICK PT

Provider Business Mailing Address
First Line	:	1665 EL PASO AVE
Second Line	:
City	:	CLOVIS
State	:	CA
Zip	:	93611-6603
Country	:	US
Telephone Number	:	559-297-7052
Fax Number	:	559-431-3267

Provider Business Practice Location Address
First Line	:	7265 N 1ST ST
Second Line	:	SUITE 105 & 103
City	:	FRESNO
State	:	CA
Zip	:	93720-2956
Country	:	US
Telephone Number	:	559-438-0598
Fax Number	:	559-431-3267

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	07/08/2007

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Directions to “ KAREN A TIFTICK PT” Practice Location

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