Provider First Line Business Practice Location Address:
9844 S. 1300 E.
Provider Second Line Business Practice Location Address:
LIFE CENTRE ATHLETIC CLUB
Provider Business Practice Location Address City Name:
SANDY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84094
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-816-0167
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/24/2008