Individual
MR. CLIFFORD P KNELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
328 WARNER DR, STE 8, LEWISTON, ID 83501-4441
(208) 746-7573
(208) 746-4519
Mailing address
328 WARNER DR, STE 8, LEWISTON, ID 83501-4441
(208) 746-7573
(208) 746-4519
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT00008736
WA
225100000X
Physical Therapist
Primary
PT1687
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806463200
—
ID
Enumeration date
06/06/2006
Last updated
06/29/2010
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