Organization
GRANGER MEDICAL SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JANE PENNINGTON MD (PRESIDENT/CEO)
(801) 965-3600
Entity
Organization
Contact information
Practice address
2965 W 3500 S, WEST VALLEY CITY, UT 84119-3602
(801) 965-3600
Mailing address
7181 S CAMPUS VIEW DR STE 200, WEST JORDAN, UT 84084-4312
(801) 965-3600
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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