Provider First Line Business Practice Location Address:
1280 E STRINGHAM AVE
Provider Second Line Business Practice Location Address:
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:
84106-2490
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-581-2000
Provider Business Practice Location Address Fax Number:
801-585-2891
Provider Enumeration Date:
12/07/2011