| NPI | 1265907620 |
|---|---|
| Other Name | OPTICAL SHOP (MURRAY) |
| Doing Business As | REVERE HEALTH |
| Entity Type | Organization |
| Authorized Contact | JED BRADLEY HARSTON Director Of Managed Care 801-812-5012 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2018-10-11 |