Provider First Line Business Practice Location Address:
8 TH AVE C ST PROMISE HOSPITAL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SLC
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84143-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
385-212-0677
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/25/2007