Provider First Line Business Practice Location Address:
573 N 1000 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEARFIELD
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84015-9368
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-776-1000
Provider Business Practice Location Address Fax Number:
801-776-5277
Provider Enumeration Date:
12/19/2006