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Individual

CORY CALLAHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
410 N STATE OF FRANKLIN RD STE 140, JOHNSON CITY, TN 37604-6972
(423) 431-2460
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5089
TN
363A00000X
Physician Assistant
PA1675
ME
363AS0400X
Surgical Physician Assistant
Primary
5089
TN

Other

Enumeration date
02/07/2017
Last updated
02/27/2024
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