Provider Demographics
NPI:1922003417
Name:HARWARD, JOSHUA A (MPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:A
Last Name:HARWARD
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9720 S. 1300 E.
Mailing Address - Street 2:#W200
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094
Mailing Address - Country:US
Mailing Address - Phone:801-572-0690
Mailing Address - Fax:801-572-0696
Practice Address - Street 1:74 E. KIMBALL LANE
Practice Address - Street 2:#200
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020
Practice Address - Country:US
Practice Address - Phone:801-432-2070
Practice Address - Fax:804-432-2058
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5300648-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ80082Medicare PIN
UT80082Medicare PIN