Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 1032980501 | UT |
N | 222Z00000X | Podiatrist | 1032980501 | UT |
Y | 213EP1101X | Primary Podiatric Medicine | 103298-0501 | UT |
NPI | 1124058672 |
---|---|
Provider Name | Shirl Curtis Cowley |
First Address | St George, UT 84770 |
Second Address | St George, UT 84770 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 13/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T48828 | (02) |