| Granger Medical Clinic Pc | |
|
2356 N 400 E Ste 201 Tooele UT 84074-3409 | |
| (801) 352-5900 | |
| (801) 352-5914 |
| Full Name | Granger Medical Clinic Pc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2356 N 400 E Ste 201, Tooele, Utah |
| Authorized Official Name and Position | Mary Jane Pennington (PRESIDENT) |
| Authorized Official Contact | 8019653600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Granger Medical Clinic Pc 2965 W 3500 S West Valley City UT 84119-3602 Ph: (801) 965-3600 | Granger Medical Clinic Pc 2356 N 400 E Ste 201 Tooele UT 84074-3409 Ph: (801) 352-5900 |
| NPI Number | 1073811733 |
|---|---|
| Provider Enumeration Date | 03/04/2011 |
| Last Update Date | 12/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073811733 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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