Provider First Line Business Practice Location Address:
DEPARTMENT OF PSYCHIATRY
Provider Second Line Business Practice Location Address:
30 N. 1900 E.
Provider Business Practice Location Address City Name:
SLC
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84132-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-581-7951
Provider Business Practice Location Address Fax Number:
801-581-5604
Provider Enumeration Date:
04/25/2008