Organization
UTAH INJURY CLINIC, LLC
Active
Parent organization
PRALINE CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRALINE CORPORATION
Authorized official
DR. TOM E GRANT JR. DC (MANAGER)
(801) 747-2886
Entity
Organization
Contact information
Practice address
4700 S 900 E STE 41G, SALT LAKE CITY, UT 84117-4938
(801) 747-2886
(801) 716-3532
Mailing address
4700 S 900 E STE 41G, SALT LAKE CITY, UT 84117-4938
(801) 376-9596
(801) 716-3532
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
6715760-1202
UT
Other
Enumeration date
02/13/2009
Last updated
03/01/2012
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