Provider First Line Business Practice Location Address:
1380 E MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST GEORGE
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84790-2123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-251-2205
Provider Business Practice Location Address Fax Number:
435-251-2202
Provider Enumeration Date:
02/07/2006