Provider First Line Business Practice Location Address:
DEPT VASCULAR SURGEY
Provider Second Line Business Practice Location Address:
30 NORTH 1900 EAST, ROOM 3C 344 SOM
Provider Business Practice Location Address City Name:
SALT LAKE CITY
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:
801-581-8301
Provider Business Practice Location Address Fax Number:
801-581-3433
Provider Enumeration Date:
06/02/2008