Individual
GRANT WILLIAM THATCHER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
VA SALT LAKE CITY HEALTH CARE SYSTEM, 500 FOOTHILL DRIVE, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
4344 LARSON WAY, SALT LAKE CITY, UT 84124-2718
(801) 278-7834
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
156374-1205
UT
Other
Enumeration date
06/13/2006
Last updated
07/08/2007
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