Revive Health Center Of Utah Llc

NPI 1184042236 - Licensed Practical Nurse - 164W00000X

NPI Details
NPI 1184042236
Enumeration Date 04/04/2014
Last Updated 04/04/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name JACOB JACOB
Position ADMINISTRATOR
Phone (801) 820-6585
Fax
Practice Location
3080 N FAIRFIELD RD
SUITE 1
LAYTON UT, 84041-8694, US
Phone (801) 820-6585
Fax
Business Location
3080 N FAIRFIELD RD
SUITE 1
LAYTON UT, 84041-8694, US
Phone (801) 820-6585
Fax
Toxanomy
Taxonomy Code 164W00000X
License State Utah
License Number 1851542872
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According to our database, Revive Health Center Of Utah Llc NPI is 1184042236, taxonomy code is 164W00000X and license number is 1851542872, license state is located at Utah. Revive Health Center Of Utah Llc physically located at 3080 N Fairfield Rd, Layton UT, 84041-8694. NPI Number 1033115704 has the healthcare provider type.

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1184042236 NPI number is provided on an as is basis without warranty of any kind. 1184042236 is maintained by the National Plan & Provider Enumeration System. The contents of Revive Health Center Of Utah Llc are for informational purposes only.