Individual
MR. JOHN PATRICK BYRNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
100 S 1000 W, TOOELE, UT 84074-4010
(435) 843-3520
Mailing address
100 S 1000 W, TOOELE, UT 84074-4010
(435) 843-0877
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
135723-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107002316101
INTERMOUNTAIN HEALTH CARE
UT
01
—
35510
DESERET MUTUAL
UT
01
—
942938348006
CHAMPUS
UT
01
—
942938348BY1
EDUCATORS MUTUAL
UT
Enumeration date
01/25/2006
Last updated
03/17/2008
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