Provider First Line Business Mailing Address:
PO BOX 413021
Provider Second Line Business Mailing Address:
DIVISION OF PED NEUROLOGY, PRIMARY CHILDREN'S HOSPITAL
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84141-3021
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-213-3900
Provider Business Mailing Address Fax Number: