Provider First Line Business Practice Location Address:
250 W 300 N
Provider Second Line Business Practice Location Address:
UINTAH BASIN MEDICAL CENTER
Provider Business Practice Location Address City Name:
ROOSEVELT
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84066
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-722-4691
Provider Business Practice Location Address Fax Number:
435-722-6103
Provider Enumeration Date:
03/29/2011