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General NPI Number Information
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NPI Number | 1770452781
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Entity Type | Organization
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Legal Business Name | DESERET ROCK PAIN SPECIALISTS, LLC
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 3665 S 8400 W STE 200
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City | MAGNA
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State | UT
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Zip | 84044-4908
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Country | US
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Telephone | 801-628-4157
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Fax |
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Provider Business Mailing Address
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Address Line | 3665 S 8400 W STE 200
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City | MAGNA
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State | UT
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Zip | 84044-4908
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. BRADEN J WEBB
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Credential | DO
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Telephone | 801-628-4157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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