Provider First Line Business Practice Location Address:
INTERMOUNTAIN VOICE & SWALLOWING CTR
Provider Second Line Business Practice Location Address:
440 D STREET, SUITE 202
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:
84143-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-480-4972
Provider Business Practice Location Address Fax Number:
801-480-1810
Provider Enumeration Date:
05/14/2007