Provider First Line Business Practice Location Address:
382 W CARE CAMPUS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOAB
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84532-2331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-719-3988
Provider Business Practice Location Address Fax Number:
435-719-3971
Provider Enumeration Date:
11/29/2023