Provider First Line Business Practice Location Address:
6360 S 3000 E STE 200
Provider Second Line Business Practice Location Address:
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:
84121-6925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-797-8000
Provider Business Practice Location Address Fax Number:
855-769-3885
Provider Enumeration Date:
04/15/2014