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Individual

MR. DAMION D. RODEBACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1449 N 1400 W STE 22, ST GEORGE, UT 84770-5237
(435) 703-9296
(435) 215-4075
Mailing address
732 N MAIN ST, SPRINGVILLE, UT 84663-1034
(801) 704-7001
(801) 806-0383

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
54658
CA
363A00000X
Physician Assistant
54658
CA
363A00000X
Physician Assistant
Primary
65833191206
UT
363AS0400X
Surgical Physician Assistant
PA60677483
WA

Other

Enumeration date
05/01/2016
Last updated
05/02/2024
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