Organization
GRANGER MEDICAL CLINIC, PC
Active
Parent organization
GRANGER MEDICAL CLINIC, PC
Other names
Granger Medical Clinic - Millcreek Allergy
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRANGER MEDICAL CLINIC, PC
Authorized official
ANNE WHITAKER (CREDENTIALING COORDINATOR)
(801) 965-3505
Entity
Organization
Contact information
Practice address
1121 E 3900 S, SUITE #C130, SALT LAKE CITY, UT 84124-1214
(801) 281-1300
Mailing address
1121 E 3900 S, SUITE #C130, SALT LAKE CITY, UT 84124-1214
(801) 281-1300
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1773041205
UT
Other
Enumeration date
08/25/2006
Last updated
01/21/2015
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