Organization
GRANGER MEDICAL PARK CITY
Active
Parent organization
GRANGER MEDICAL CLINIC INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRANGER MEDICAL CLINIC INC
Authorized official
MRS. MARY JANE PENNINGTON MD (PRESIDENT)
(801) 965-3600
Entity
Organization
Contact information
Practice address
3181 W 9000 SO, WEST JORDAN, UT 84088
(801) 569-5520
(801) 352-5951
Mailing address
1600 SNOW CREEK DR STE B, PARK CITY, UT 84060-7372
(801) 569-5520
(801) 352-5951
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/19/2011
Last updated
05/13/2013
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