Provider First Line Business Practice Location Address:
8TH AVE & C STREET
Provider Second Line Business Practice Location Address:
LDS HOSPITAL
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84143-1005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-408-1006
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2006