Provider First Line Business Practice Location Address:
DEPARTMENT OF NEUROSURGERY 175 NORTH MEDICAL DRIVE EAST
Provider Second Line Business Practice Location Address:
5TH FLOOR
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:
84132-2303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-574-8459
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/08/2023