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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 (PRESIDENT)
(801) 965-3600
Entity
Organization

Contact information

Practice address
2356 N 400 E STE 201, TOOELE, UT 84074-3409
(801) 352-5900
(801) 352-5914
Mailing address
2965 W 3500 S, WEST VALLEY CITY, UT 84119-3602
(801) 965-3600

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
03/04/2011
Last updated
12/13/2023
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