Provider First Line Business Practice Location Address:
104 W MEDICAL DR STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SARATOGA SPRINGS
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84045-3191
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-955-3600
Provider Business Practice Location Address Fax Number:
801-955-3600
Provider Enumeration Date:
08/23/2023