Provider First Line Business Practice Location Address:
8TH AVENUE AND C STREET
Provider Second Line Business Practice Location Address:
SOLID ORGAN TRANSPLANT
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:
84143-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-408-1242
Provider Business Practice Location Address Fax Number:
801-408-8679
Provider Enumeration Date:
02/10/2006