Provider First Line Business Practice Location Address:
UNIVERSITY OF UTAH HEALTHCARE
Provider Second Line Business Practice Location Address:
30 NORTH 1900 EAST; AB193 SOM
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:
801-587-9103
Provider Business Practice Location Address Fax Number:
801-585-3384
Provider Enumeration Date:
07/27/2006