Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 275723-1205 | UT |
NPI | 1053407726 |
---|---|
Provider Name | Tom V Cloward |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Salt Lake City, UT 84143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 17/11/2010 |