Provider First Line Business Practice Location Address:
230 N HOSPITAL DR
Provider Second Line Business Practice Location Address:
STE 4
Provider Business Practice Location Address City Name:
PRICE
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84501-4221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-637-2300
Provider Business Practice Location Address Fax Number:
435-637-1581
Provider Enumeration Date:
10/10/2012