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Organization

GRANGER MEDICAL SPECIALISTS LLC

Active
Parent organization
GRANGER MEDICAL SPECIALISTS LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
GRANGER MEDICAL SPECIALISTS LLC
Authorized official
MARY JANE PENNINGTON MD (PRESIDENT/CEO)
(801) 965-3600
Entity
Organization

Contact information

Practice address
96 E KIMBALLS LN STE 304, DRAPER, UT 84020-5021
(801) 571-9433
Mailing address
7181 S CAMPUS VIEW DR STE 200, WEST JORDAN, UT 84084-4312
(801) 965-3505

Taxonomy

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

Other

Enumeration date
04/19/2022
Last updated
04/19/2022
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