# GRANGER MEDICAL SLEEP CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GRANGER MEDICAL CLINIC, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1285043596
- **Legal business name:** GRANGER MEDICAL CLINIC, INC.
- **Authorized official:** MRS. ANNE WHITAKER (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (801) 965-3505

## Contact information

- **Practice address:** 3181 W 9000 S, WEST JORDAN, UT 84088-5610
- **Practice address phone:** (801) 352-5950
- **Practice address fax:** (801) 352-5550
- **Mailing address:** 3181 W 9000 S, WEST JORDAN, UT 84088-5610
- **Mailing address phone:** (801) 352-5950
- **Mailing address fax:** (801) 352-5550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | 5139563-1205 | UT | Yes |

## Other

- **Enumeration date:** 08/12/2014
- **Last updated:** 08/12/2014