Organization
GRANGER MEDICAL CLINIC, INC.
Active
Parent organization
GRANGER MEDICAL CLINIC, INC.
Other names
Granger Medical Millcreek
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRANGER MEDICAL CLINIC, INC.
Authorized official
ANNE WHITAKER (CREDENTIALING COORDINATOR)
(801) 965-3505
Entity
Organization
Contact information
Practice address
1250 E 3900 S, SUITE 250, SALT LAKE CITY, UT 84124-1348
(801) 268-6283
(801) 263-3579
Mailing address
1250 E 3900 S, SUITE 250, SALT LAKE CITY, UT 84124-1348
(801) 268-6283
(801) 263-3579
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
050912
UT
Other
Enumeration date
07/14/2014
Last updated
07/14/2014
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