Healthcare Provider Details

I. General information

NPI: 1255171617
Provider Name (Legal Business Name): IVEE RESTORATIVE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 N MAIN ST STE 3
SPANISH FORK UT
84660-1763
US

IV. Provider business mailing address

903 S 770 E
SPANISH FORK UT
84660-2488
US

V. Phone/Fax

Practice location:
  • Phone: 385-985-3565
  • Fax:
Mailing address:
  • Phone: 801-592-2539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: IVEE RESTORATIVE CARE
Title or Position: OWNER/CEO
Credential: BSN
Phone: 801-592-2539