Granger Medical Clinic PC
NPI #1356425672 in Salt Lake City, Utah
Provider Information
- NPI Number
- 1356425672
- Entity Type
- Organization
- Organization Name
- Granger Medical Clinic PC
- Primary Specialty
- Specialist
- Enumeration Date
- Oct 24, 2006
- Last Updated
- Dec 10, 2015
Practice Location
- Address
- 348 E 4500 S
- Address 2
- SUITE 200
- City
- Salt Lake City
- State
- Utah
- ZIP Code
- 84107-3906
- Phone
- (801) 262-9800
Authorized Official
- Name
- DR. MARY JANE PENNINGTON, M.D.
- Title
- BOARD MEMBER
- Phone
- (801) 965-3600
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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