Provider Demographics
NPI:1447907530
Name:CLUFF, LOIS TEAN FINICUM
Entity type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:TEAN FINICUM
Last Name:CLUFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:TEAN
Other - Last Name:FINICUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918
Mailing Address - Street 2:
Mailing Address - City:COLORADO CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86021-0918
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:451 CANEBEDS RD
Practice Address - Street 2:
Practice Address - City:CANE BEDS
Practice Address - State:AZ
Practice Address - Zip Code:86021
Practice Address - Country:US
Practice Address - Phone:928-925-2073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10865551174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist