Provider Demographics
NPI:1144528092
Name:CLIFTON, CLARENCE HERBERT III (DPT)
Entity type:Individual
Prefix:
First Name:CLARENCE
Middle Name:HERBERT
Last Name:CLIFTON
Suffix:III
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:CHIP
Other - Middle Name:
Other - Last Name:CLIFTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:800 CRESCENT CENTRE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7285
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-221-9054
Practice Address - Street 1:4957 SWINYAR DR STE 103
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-2205
Practice Address - Country:US
Practice Address - Phone:423-664-0800
Practice Address - Fax:423-664-0801
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7856225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist