NPI | 1144439068 |
---|---|
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 | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2007-05-21 |
Last Update Date | 2018-03-07 |