Provider First Line Business Practice Location Address:
300 NORTH 1900 EAST, RM. 4C104
Provider Second Line Business Practice Location Address:
UNIV OF UTAH MEDICINE PEDIATRICS RESIDENCY 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:
84132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-221-2143
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/09/2012