Provider First Line Business Practice Location Address:
25 NORTH 100 EAST
Provider Second Line Business Practice Location Address:
FAMILY HEALTHCARE
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-879-5126
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/03/2011