Provider First Line Business Practice Location Address:
DIV OF MEDICAL GENETICS, SOM 2C412
Provider Second Line Business Practice Location Address:
UNIV OF UTAH HEALTH SCIENCES CTR, 50 N MEDICAL DR
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:
84132-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-581-8943
Provider Business Practice Location Address Fax Number:
801-585-7252
Provider Enumeration Date:
10/14/2005