| NPI | 1841433927 |
|---|---|
| Doing Business As | REVERE HEALTH |
| Entity Type | Organization |
| Authorized Contact | JED HARSTON Director Of Managed Care 801-812-5012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2018-03-07 |