Provider First Line Business Practice Location Address:
5770 SOUTH 1550 WEST, BLDG G
Provider Second Line Business Practice Location Address:
PRIMARY CHILDREN'S COUNSELING CENTER
Provider Business Practice Location Address City Name:
TAYLORSVILLE
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-313-7770
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/02/2016