Provider First Line Business Practice Location Address:
30 N. 1900 EAST, MREB 307
Provider Second Line Business Practice Location Address:
UNIVERSITY OF UTAH SCHOOL OF MEDICINE, DEPT. OF SURGERY
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-585-7280
Provider Business Practice Location Address Fax Number:
801-587-9370
Provider Enumeration Date:
11/03/2007