Provider First Line Business Practice Location Address:
100 MARIO CAPECCHI DRIVE
Provider Second Line Business Practice Location Address:
PCMC REHAB MAIN CAMPUS 100 N. MARIO CAPECCHI DR.
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:
84113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-662-4949
Provider Business Practice Location Address Fax Number:
303-764-8214
Provider Enumeration Date:
02/28/2007