Provider Demographics
NPI:1255171617
Name:IVEE RESTORATIVE CARE
Entity type:Organization
Organization Name:IVEE RESTORATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:IVEE
Authorized Official - Middle Name:RESTORATIVE
Authorized Official - Last Name:CARE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:801-592-2539
Mailing Address - Street 1:903 S 770 E
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-2488
Mailing Address - Country:US
Mailing Address - Phone:801-592-2539
Mailing Address - Fax:
Practice Address - Street 1:92 N MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1763
Practice Address - Country:US
Practice Address - Phone:385-985-3565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service