| NPI | 1780017954 | 
|---|---|
| Doing Business As | REVERE HEALTH | 
| Entity Type | Organization | 
| Authorized Contact | JED HARSTON Director Of Managed Care 801-812-5012  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery | 
| Enumeration Date | 2013-08-12 | 
| Last Update Date | 2018-03-07 |