Provider First Line Business Practice Location Address:
FAMILY MEDICINE CLINIC
Provider Second Line Business Practice Location Address:
150 N 100 W SUITE N102
Provider Business Practice Location Address City Name:
VERNAL UTAH
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-789-3342
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/14/2021