Provider First Line Business Practice Location Address:
845 EAST 4800 SOUTH SUITE 200
Provider Second Line Business Practice Location Address:
SUN DANCE BEHAVIORAL RESOURCES LLC
Provider Business Practice Location Address City Name:
MURRAY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-264-9522
Provider Business Practice Location Address Fax Number:
801-265-9604
Provider Enumeration Date:
11/07/2006