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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
2019 E RIVERSIDE DR, SUITE A200, ST GEORGE, UT 84790-8134
(435) 628-9298
(435) 628-9655
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
207RH0003X
Hematology & Oncology Physician
Primary
—
NULL
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Enumeration date
02/22/2013
Last updated
03/07/2018
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