| NPI | 1437205028 |
|---|---|
| Doing Business As | REVERE HEALTH |
| Entity Type | Organization |
| Authorized Contact | JED HARSTON Director Of Managed Care 801-812-5012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: UT 2007ASF78284) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2018-03-07 |