Provider First Line Business Practice Location Address:
1340 E. 300 N.
Provider Second Line Business Practice Location Address:
SHRINERS HOSPITAL FOR CHILDREN
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:
84103-4399
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-536-3600
Provider Business Practice Location Address Fax Number:
801-536-3868
Provider Enumeration Date:
11/24/2006