Provider First Line Business Practice Location Address:
50 N MEDICAL DR,
Provider Second Line Business Practice Location Address:
UNIVERSITY HOSPITAL
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:
84112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-760-7244
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/17/2015