Individual
CHAD RYAN REBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
340 E 100 S, SALT LAKE CITY, UT 84111-1702
(801) 428-3500
(801) 322-2831
Mailing address
320 E 2ND ST, LIBBY, MT 59923-2010
(406) 283-6900
(406) 293-6622
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
8776901-1206
UT
363A00000X
Physician Assistant
Primary
MED-PAC-LIC-41920
MT
Other
Enumeration date
08/29/2013
Last updated
02/19/2024
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