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Organization
ROSE CREEK PEDIATRICS, LLC
Active
Organization
ROSE CREEK PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WOODROW CANNON MARRIOTT MD (MANAGING MEMBER)
(801) 842-7366
Entity
Organization
Contact information
Practice address
4121 W 13400 S UNIT B, RIVERTON, UT 84096-6412
(801) 842-7366
Mailing address
869 E 4500 S # 261, SALT LAKE CITY, UT 84107-3049
(801) 842-7366
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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