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General NPI Number Information
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NPI Number | 1821189416
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Entity Type | Organization
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Legal Business Name | THOMAS N GLOW DPM PC
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3965 FOOTHILLS DR STE B
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City | SIERRA VISTA
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State | AZ
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Zip | 85635
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Country | US
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Telephone | 520-458-6838
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Fax | 520-458-0373
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Provider Business Mailing Address
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Address Line | 3965 FOOTHILLS DR STE B
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City | SIERRA VISTA
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State | AZ
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Zip | 85635
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Country | US
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Telephone | 520-458-6838
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Fax | 520-458-0373
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS N GLOW
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Credential | DPM PC
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Telephone | 520-458-6838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 87
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License Number State | AZ
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