Provider Demographics
NPI:1710606975
Name:REAL YOU PLASTIC SURGERY AND WELLNESS, LLC
Entity Type:Organization
Organization Name:REAL YOU PLASTIC SURGERY AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MECHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-756-5600
Mailing Address - Street 1:48 N 1100 E STE A
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2910
Mailing Address - Country:US
Mailing Address - Phone:801-885-1300
Mailing Address - Fax:
Practice Address - Street 1:48 N 1100 E STE A
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2910
Practice Address - Country:US
Practice Address - Phone:801-885-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-23
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty