Granger Medical Clinic, PC

NPI #1932216652 in Salt Lake City, Utah

Provider Information

NPI Number: 1932216652
Entity Type: Organization
Organization Name: Granger Medical Clinic, PC
Subpart: Yes (part of a larger organization)
Parent Organization: GRANGER MEDICAL CLINIC, PC
Primary Specialty: Specialist
Enumeration Date: Aug 25, 2006
Last Updated: Jan 21, 2015

Practice Location

Address: 1121 E 3900 S
Address 2: SUITE #C130
City: Salt Lake City
State: Utah
ZIP Code: 84124-1214
Phone: (801) 281-1300

Authorized Official

Name: ANNE WHITAKER
Title: CREDENTIALING COORDINATOR
Phone: (801) 965-3505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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