NPI 1417870130

Timothy Cleveland

Practitioner Prosthetist Boise, ID

Practice location

Address: 2109 W Jefferson St, Boise, ID 83702-4927
Phone: (208) 918-5768

Registered specialties

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X Licence CPO03999 (ID)

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Registry record

NPI: 1417870130
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Jul 2026
Record last updated: 31 Jul 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.