| Revive Sport & Spine | |
|
7351 S Union Park Ave Ste 150, Midvale, UT 84047-1869 | |
| (801) 944-1855 | |
| (385) 351-5950 |
| Full Name | Revive Sport & Spine |
|---|---|
| Type | Facility |
| Speciality | Chiropractor - Sports Physician |
| Location | 7351 S Union Park Ave Ste 150, Midvale, 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 7351 S Union Park Ave Ste 150, Midvale, UT 84047-1869 Ph: (801) 944-1855 | Revive Sport & Spine 7351 S Union Park Ave Ste 150, Midvale, UT 84047-1869 Ph: (801) 944-1855 |
Dr. Andrew J Reheisse, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 7351 S Union Park Ave Ste 150, Midvale, UT 84047 Phone: 801-944-1855 Fax: 385-351-5950 | |
Campbell Injury Clinic Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 115 E 7200 S, Midvale, UT 84047 Phone: 801-448-1895 Fax: 801-566-4476 | |
Craig D Campbell, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 115 Fort Union Blvd, Midvale, UT 84047 Phone: 801-566-4357 Fax: 801-566-4476 | |
Jordan Mousley, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 6717 S 900 E Ste 101, Midvale, UT 84047 Phone: 801-432-7511 Fax: 801-432-7516 | |
Jack Scott Tripp, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 115 E 7200 S, Midvale, UT 84047 Phone: 801-566-4357 Fax: 801-566-4476 | |
Sports Chiropractic Of Utah Llc Chiropractor Medicare: Medicare Enrolled Practice Location: 6717 S 900 E Ste 101, Midvale, UT 84047 Phone: 406-381-7577 | |
Dr. Eric Lee Cheney, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 44 W 7200 S, Ste. B, Midvale, UT 84047 Phone: 801-259-3308 |