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Organization
GRANGER MEDICAL CLINIC PC
Active
Organization
GRANGER MEDICAL CLINIC PC
Active
Parent organization
GRANGER MEDICAL CLINIC PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRANGER MEDICAL CLINIC PC
Authorized official
MARY JANE PENNINGTON MD (PRESIDENT)
(801) 965-3600
Entity
Organization
Contact information
Practice address
9844 S 1300 E STE 100, SANDY, UT 84094-4600
(801) 965-3600
Mailing address
2965 W 3500 S, WEST VALLEY CITY, UT 84119-3602
(801) 965-3505
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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