Provider First Line Business Practice Location Address:
415 EAST 3900 SOUTH
Provider Second Line Business Practice Location Address:
MALIHEH FREE CLINIC
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:
84107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-266-3700
Provider Business Practice Location Address Fax Number:
801-266-3721
Provider Enumeration Date:
12/17/2013