Provider First Line Business Practice Location Address:
UNIVERSITY OF UTAH, DIVISION OF PEDIATRIC EMERGENCY MED
Provider Second Line Business Practice Location Address:
295 CHIPETA WAY
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:
84108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-587-7400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/22/2011