Individual
JOSHUA CLARK GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
159 N MAIN ST, MANTI, UT 84642-1257
(435) 835-3344
(435) 835-3081
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12722421-1206
UT
363AM0700X
Medical Physician Assistant
12722421-1206
UT
363AM0700X
Medical Physician Assistant
12722421-8906
UT
363AM0700X
Medical Physician Assistant
PA11173
TX
Other
Enumeration date
02/13/2017
Last updated
03/09/2023
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