Provider First Line Business Practice Location Address:
230 N HOSPITAL DR STE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRICE
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84501-4222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-637-6797
Provider Business Practice Location Address Fax Number:
435-637-1123
Provider Enumeration Date:
02/18/2016