Individual
TIMOTHY CLEVELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2109 W JEFFERSON ST, BOISE, ID 83702-4927
(208) 918-5768
Mailing address
2109 W JEFFERSON ST, BOISE, ID 83702-4927
(208) 918-5768
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
CPO03999
ID
Other
Enumeration date
07/31/2026
Last updated
07/31/2026
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