Individual
CRAIG AARON PACKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2356 N 400 E, STE 102, TOOELE, UT 84074
(435) 833-9180
(435) 833-9177
Mailing address
2356 N 400 E, STE 102, TOOELE, UT 84074
(435) 833-9180
(435) 833-9177
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
51058218002
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D4703
—
UT
Enumeration date
09/09/2006
Last updated
07/15/2019
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