Provider First Line Business Practice Location Address:
1266 LEGEND HILLS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEARFIELD
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84015-2274
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-776-6000
Provider Business Practice Location Address Fax Number:
801-776-1166
Provider Enumeration Date:
06/18/2006