| NPI | 1609046853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS DEE CALLAHAN President 435-656-5323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: UT 1594201205) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2014-02-18 |