Provider First Line Business Mailing Address:
85 N. MEDICAL DR., EAST RM. 201
Provider Second Line Business Mailing Address:
C/O DIALYSIS PROGRAM - UNIVERSITY OF UTAH
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84112-5350
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-581-8573
Provider Business Mailing Address Fax Number: