Healthcare Provider Details

I. General information

NPI: 1902193071
Provider Name (Legal Business Name): PAUL J HARWARD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2011
Last Update Date: 07/13/2022
Certification Date: 07/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 E 1100 N
AMERICAN FORK UT
84003-3226
US

IV. Provider business mailing address

519 W CENTER ST
PLEASANT GROVE UT
84062-2215
US

V. Phone/Fax

Practice location:
  • Phone: 801-310-6880
  • Fax:
Mailing address:
  • Phone: 801-310-6880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: