Organization · Type 2 NPI

Revere Health PC

Multi-Specialty Clinic/Center · Provo, UT

NPI number 1093764805 Active

Practice location

1055 N 500 W
Provo, UT 84604-3305

Fax (801) 429-8150

Specialties and licenses

TaxonomyCodeLicense
Multi-Specialty Clinic/Center Primary 261QM1300XNone listed

Multi-Specialty Clinic/Center: Definition to come...

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About NPI 1093764805

Revere Health PC's National Provider Identifier is 1093764805, issued on May 9, 2006. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Provo, UT. The record was last updated on Jun 15, 2026.