Healthcare Provider Details

I. General information

NPI: 1710606975
Provider Name (Legal Business Name): REAL YOU PLASTIC SURGERY AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 05/16/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 N 1100 E STE A
AMERICAN FORK UT
84003-2910
US

IV. Provider business mailing address

48 N 1100 E STE A
AMERICAN FORK UT
84003-2910
US

V. Phone/Fax

Practice location:
  • Phone: 801-885-1300
  • Fax:
Mailing address:
  • Phone: 801-885-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ELISE M MECHAM
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 801-756-5600