Organization
GRANGER MEDICAL SPECIALISTS LLC
Active
Parent organization
GRANGER MEDICAL SPECIALISTS OOC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRANGER MEDICAL SPECIALISTS OOC
Authorized official
MARY JANE PENNINGTON MD (CEO/PRESIDENT)
(801) 965-3600
Entity
Organization
Contact information
Practice address
3181 W 9000 S, WEST JORDAN, UT 84088-5610
(801) 965-3600
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
04/05/2022
Last updated
04/05/2022
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