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General NPI Number Information
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NPI Number | 1801113147
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Entity Type | Organization
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Legal Business Name | PEAK HEALTHCARE, INC
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Dates
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Enumeration Date | 04/27/2010
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Last Update Date | 04/27/2010
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Provider Practice Location Address
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Address Line | 894 E 100 N SUITE 3
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City | PRICE
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State | UT
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Zip | 84501-2711
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Country | US
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Telephone | 435-637-2324
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Fax | 435-637-2326
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Provider Business Mailing Address
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Address Line | 894 E 100 N SUITE 3
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City | PRICE
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State | UT
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Zip | 84501-2711
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Country | US
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Telephone | 435-637-2324
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Fax | 435-637-2326
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT/OWNER
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Name | MR. TIMOTHY ADAM CALLAHAN
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Credential | P.A.-C
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Telephone | 435-637-2324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 363AM0700X
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License Number State | UT
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