Provider First Line Business Practice Location Address:
UNIVERSITY OF UTAH HOSPITAL 30 NORTH 1900
Provider Second Line Business Practice Location Address:
1C412
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:
84132-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-581-2401
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2013