Provider First Line Business Practice Location Address:
8TH AVENUE AND C STREET
Provider Second Line Business Practice Location Address:
BLOOD AND MARROW TRANSPLANT/LEUKEMIA PROGRAM
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:
84103-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-408-3043
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/26/2007