MR. Bruce Mcclanahan Burnham, PHYSICIAN ASSISTANT

NPI #1760695514 in Provo, Utah

Provider Information

NPI Number: 1760695514
Entity Type: Individual
Name: MR. Bruce Mcclanahan Burnham, PHYSICIAN ASSISTANT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PHYSICIAN ASSISTANT
Enumeration Date: May 8, 2007
Last Updated: Dec 27, 2013

Practice Location

Address: 3152 NORTH UNIVERSITY AVE
Address 2: SUITE 120
City: Provo
State: Utah
ZIP Code: 84604
Phone: (801) 375-2177

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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