Provider First Line Business Practice Location Address:
WELLSPACE UTAH PLLC
Provider Second Line Business Practice Location Address:
60 SOUTH 600 EAST STE 100
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:
84102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-906-0525
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/06/2024