Provider First Line Business Practice Location Address:
DIVISION OF GERIATRICS UNIVERISITY OF UTAH
Provider Second Line Business Practice Location Address:
30N. 1900E. 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:
801-585-3884
Provider Enumeration Date:
09/14/2007