Organization
ROGUE REHABILITATION AND PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM SCHILTZ DPT (OWNER)
(503) 975-5149
Entity
Organization
Contact information
Practice address
1470 400 WEST, SALT LAKE CITY, UT 84115
(503) 975-5149
Mailing address
1547 W DUPONT AVE, SALT LAKE CITY, UT 84116-3608
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528477635
—
UT
Enumeration date
05/21/2021
Last updated
05/21/2021
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