| NPI | 1689003550 |
|---|---|
| Doing Business As | REVERE HEALTH |
| Entity Type | Organization |
| Authorized Contact | JED HARSTON Director Of Managed Care 801-812-5012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2018-03-08 |