Provider First Line Business Practice Location Address:
50 N. MEDICAL DR.
Provider Second Line Business Practice Location Address:
DEPT OF SOCIAL WORK
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:
801-585-2847
Provider Business Practice Location Address Fax Number:
801-585-2818
Provider Enumeration Date:
01/26/2007