Provider Demographics
NPI:1063839736
Name:CLAWSON, COLEBY (DPT)
Entity Type:Individual
Prefix:
First Name:COLEBY
Middle Name:
Last Name:CLAWSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 E 400 S
Mailing Address - Street 2:STE G
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-2027
Mailing Address - Country:US
Mailing Address - Phone:801-704-9405
Mailing Address - Fax:801-704-9407
Practice Address - Street 1:655 E 400 S
Practice Address - Street 2:STE G
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-2027
Practice Address - Country:US
Practice Address - Phone:801-704-9405
Practice Address - Fax:801-704-9407
Is Sole Proprietor?:No
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6500354-24012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic