Organization
GRANGER MEDICAL CLINIC PC
Active
Organization
GRANGER MEDICAL CLINIC PC
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
9001 S 3200 W, WEST JORDAN, UT 84088-9621
(801) 569-5520
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
06/30/2022
Last updated
06/30/2022
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