Provider First Line Business Practice Location Address:
UUMC 30 N 1900 E 4B319
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:
84132-3901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-585-9815
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/08/2014