Organization
ROAD BACK LLC
Active
Other names
The Road Back to Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK GARN RODEBACK DO (SOLE MBR)
(435) 414-9858
Entity
Organization
Contact information
Practice address
1818 MUELLER PARK RD, BOUNTIFUL, UT 84010-1105
(435) 414-9858
Mailing address
1818 MUELLER PARK RD, BOUNTIFUL, UT 84010-1105
(435) 414-9858
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
05/19/2021
Last updated
10/14/2021
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