Provider First Line Business Practice Location Address:
834 E 9400 S STE 65
Provider Second Line Business Practice Location Address:
C/O FOOT SOLUTIONS
Provider Business Practice Location Address City Name:
SANDY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84094-4111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-553-0161
Provider Business Practice Location Address Fax Number:
801-553-0171
Provider Enumeration Date:
01/07/2009