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Organization
GRANGER MEDICAL CLINIC, INC.
Active
Organization
GRANGER MEDICAL CLINIC, INC.
Active
Parent organization
GRANGER MEDICAL CLINIC, INC.
Other names
Granger Medical Clinic - Wasatch
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRANGER MEDICAL CLINIC, INC.
Authorized official
ANNE M WHITAKER (CREDENTIALING COORDINATOR)
(801) 965-3505
Entity
Organization
Contact information
Practice address
1160 E 3900 S, SUITE 1000, SALT LAKE CITY, UT 84124-1202
(801) 262-1771
(801) 288-9101
Mailing address
1160 E 3900 S, SUITE 1000, SALT LAKE CITY, UT 84124-1202
(801) 262-1771
(801) 288-9101
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
870526286
UT
Other
Enumeration date
10/04/2006
Last updated
08/16/2016
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