Provider First Line Business Practice Location Address:
165 N. UNIVERSITY AVE. FARMINGTON
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARMINGTON
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-213-3200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/12/2016