| Revive Sport & Spine | |
|
1996 E 6400 S Ste 260, Murray, UT 84121-2173 | |
| (801) 944-1855 | |
| (385) 351-5950 |
| Full Name | Revive Sport & Spine |
|---|---|
| Type | Facility |
| Speciality | Chiropractor - Sports Physician |
| Location | 1996 E 6400 S Ste 260, Murray, Utah |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649646969 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 91235421202 (Utah) | Secondary |
| 111NS0005X | Chiropractor - Sports Physician | 91235421202 (Utah) | Primary |
| Provider Name | Andrew J Reheisse |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1003217449 PECOS PAC ID: 0840410353 Enrollment ID: I20141006000949 |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Sport & Spine 1996 E 6400 S Ste 260, Murray, UT 84121-2173 Ph: (801) 944-1855 | Revive Sport & Spine 1996 E 6400 S Ste 260, Murray, UT 84121-2173 Ph: (801) 944-1855 |
Dr. Andrew J Reheisse, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 1996 E 6400 S Ste 260, Murray, UT 84121 Phone: 801-944-1855 Fax: 385-351-5950 | |
Jeremy P. Wimmer Chiropractic, Llc Chiropractor Medicare: Medicare Enrolled Practice Location: 6095 S Fashion Blvd Ste 130, Murray, UT 84107 Phone: 801-506-7890 Fax: 801-506-7891 | |
Jared Dowell, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 279 E 5900 S, Ste. 100, Murray, UT 84107 Phone: 801-261-1700 | |
Isa5417, Llc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 154 E Myrtle Ave Ste 100, Murray, UT 84107 Phone: 801-210-5050 Fax: 801-210-5050 | |
Dr. Leon Andre Erasmus, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 166 E 5900 S, Suite 107, Murray, UT 84107 Phone: 801-313-0111 Fax: 801-313-0116 | |
Dr. Jacob Jackson, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 5801 S Fashion Blvd, Suite 210, Murray, UT 84107 Phone: 801-923-2882 Fax: 801-506-0134 | |
Matthew Clark, D.C Chiropractor Medicare: Medicare Enrolled Practice Location: 5250 S Commerce Dr Ste 155, Murray, UT 84107 Phone: 801-747-7776 |