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Organization

GRANGER MEDICAL CLINIC PC

Active
Parent organization
GRANGER MEDICAL CLINIC PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
GRANGER MEDICAL CLINIC PC
Authorized official
MARY JANE PENNINGTON MD (PRESIDENT)
(801) 965-3600
Entity
Organization

Contact information

Practice address
9844 S 1300 E STE 100, SANDY, UT 84094-4600
(801) 965-3600
Mailing address
2965 W 3500 S, WEST VALLEY CITY, UT 84119-3602
(801) 965-3505

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary

Other

Enumeration date
09/19/2024
Last updated
09/19/2024
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