Provider Demographics
NPI:1770452781
Name:DESERET ROCK PAIN SPECIALISTS, LLC
Entity type:Organization
Organization Name:DESERET ROCK PAIN SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:801-628-4157
Mailing Address - Street 1:3665 S 8400 W STE 200
Mailing Address - Street 2:
Mailing Address - City:MAGNA
Mailing Address - State:UT
Mailing Address - Zip Code:84044-4908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3665 S 8400 W STE 200
Practice Address - Street 2:
Practice Address - City:MAGNA
Practice Address - State:UT
Practice Address - Zip Code:84044-4908
Practice Address - Country:US
Practice Address - Phone:801-628-4157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-30
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty