| Granger Medical Specialists Llc | |
|
12391 S 4000 W Riverton UT 84096-7012 | |
| (801) 302-1700 | |
| Not Available |
| Full Name | Granger Medical Specialists Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 12391 S 4000 W, Riverton, Utah |
| Authorized Official Name and Position | Mary Jane Pennington (PRESIDENT/CEO) |
| Authorized Official Contact | 8019653600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Granger Medical Specialists Llc 7181 S Campus View Dr Ste 200 West Jordan UT 84084-4312 Ph: (801) 965-3505 | Granger Medical Specialists Llc 12391 S 4000 W Riverton UT 84096-7012 Ph: (801) 302-1700 |
| NPI Number | 1104567882 |
|---|---|
| Provider Enumeration Date | 04/05/2022 |
| Last Update Date | 04/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104567882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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