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Organization
CENTRAL UTAH CLINIC, P.C.
Active
Organization
CENTRAL UTAH CLINIC, P.C.
Active
Other names
Revere Health
Organization subpart
No
Provider details
NPI number
Authorized official
JED HARSTON (DIRECTOR OF MANAGED CARE)
(801) 812-5012
Entity
Organization
Contact information
Practice address
736 S 900 E STE 203, ST GEORGE, UT 84790-7003
(435) 673-6131
(435) 673-8557
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
UT
Other
Enumeration date
10/03/2006
Last updated
03/07/2018
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