Provider First Line Business Practice Location Address:
1011 N CATHERINE ST
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:
84116-1600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-596-3000
Provider Business Practice Location Address Fax Number:
801-596-8887
Provider Enumeration Date:
07/11/2007