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Organization
ROAD BACK LLC
Active
Organization
ROAD BACK LLC
Active
Other names
The Road Back to Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK GARN RODEBACK DO (SOLE MBR)
(435) 414-9858
Entity
Organization
Contact information
Practice address
1818 MUELLER PARK RD, BOUNTIFUL, UT 84010-1105
(435) 414-9858
Mailing address
1818 MUELLER PARK RD, BOUNTIFUL, UT 84010-1105
(435) 414-9858
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
05/19/2021
Last updated
10/14/2021
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