Individual
MR. LUKE ALLAN COUNTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
450 WILLIAMS WAY, MOAB, UT 84532-2185
(435) 719-3500
Mailing address
27 BEHIND THE ROCKS DR, MOAB, UT 84532-3917
(616) 265-2965
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12492705-1206
UT
363A00000X
Physician Assistant
12492705-8906
UT
363A00000X
Physician Assistant
PA59778
CA
363A00000X
Physician Assistant
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Other
Enumeration date
03/24/2021
Last updated
11/29/2021
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