| NPI | 1801113147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY ADAM CALLAHAN Physician Assistant/Owner 435-637-2324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: UT 363AM0700X) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2010-04-27 |