Provider First Line Business Practice Location Address:
5242 SO. 4820 W.
Provider Second Line Business Practice Location Address:
THE CHILDREN'S CENTER
Provider Business Practice Location Address City Name:
SLC
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84118-6422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-966-4251
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/22/2008