Organization
CENTRAL UTAH CLINIC, P.C.
Active
Other names
Revere Health
Organization subpart
No
Provider details
NPI number
Authorized official
JED HARSTON (DIRECTOR OF MANGED CARE)
(801) 812-5012
Entity
Organization
Contact information
Practice address
2825 E MALL DR, ST GEORGE, UT 84790-1954
(435) 628-9393
(435) 628-9382
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
207X00000X
Orthopaedic Surgery Physician
Primary
—
UT
Other
Enumeration date
01/05/2012
Last updated
05/27/2021
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