Provider First Line Business Practice Location Address:
PRIMARY CHILDRENS REHAB BOUNTIFUL
Provider Second Line Business Practice Location Address:
280 N MAIN ST
Provider Business Practice Location Address City Name:
BOUNTIFUL
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
807-397-8707
Provider Business Practice Location Address Fax Number:
801-397-8709
Provider Enumeration Date:
08/06/2007