Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 497274861205 | UT |
NPI | 1003838434 |
---|---|
Provider Name | Tiffany S Glasgow |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Sandy, UT 84094-3712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 01/11/2021 |