Provider First Line Business Practice Location Address:
2240 E. MURRAY-HOLLADAY RD
Provider Second Line Business Practice Location Address:
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:
84117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-277-1010
Provider Business Practice Location Address Fax Number:
801-277-7016
Provider Enumeration Date:
07/28/2006