| NPI | 1134346976 |
|---|---|
| Doing Business As | REVERE HEALTH |
| Entity Type | Organization |
| Authorized Contact | JED BRADLEY HARSTON Director Of Managed Care 801-812-5012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2018-03-07 |