Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Mar 26, 2016
License(s)
12213193-1205 (UT), 12213193-1205 (UT)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 30 N 1900 E RM 1A071 | Salt Lake City, UT 84132-2140 | 801-581-2766 |
| MAILING | 30 N 1900 E RM 1A071 | Salt Lake City, UT 84132-2140 | 801-581-2766 |
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