Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CH60272853 | WA |
NPI | 1326307422 |
---|---|
Provider Name | David Lloyd Croxford |
First Address | Puyallup, WA 98372-3730 |
Second Address | Puyallup, WA 98372-3730 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2012 |
Last Update Date | 22/02/2018 |