Provider First Line Business Practice Location Address:
1354 E 3300 S STE 100
Provider Second Line Business Practice Location Address:
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:
84106-3083
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-265-8000
Provider Business Practice Location Address Fax Number:
801-265-8004
Provider Enumeration Date:
07/30/2020