Individual
JADDON TRENT ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1055 N 500 W STE 111, PROVO, UT 84604-3305
(801) 374-8999
(801) 429-8063
Mailing address
1790 SUN PEAK DR STE A103, PARK CITY, UT 84098-6625
(801) 815-9119
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1139688
UT
Other
Enumeration date
09/25/2017
Last updated
04/13/2021
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