Rodman, Blake Fung

Rodman, Blake Fung is an individual health care provider with primary practice located at 618 E Cougar Ridge Rd , Draper UT 84020-7825. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Rodman, Blake Fung can be contacted via phone (801) 450-0622.

Contact Information

Primary practice address
618 E Cougar Ridge Rd Draper UT 84020-7825
Phone: (801) 450-0622
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X

Profile Details

NPI number 1588370555
LBN Legal business name Rodman, Blake Fung
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2023
Last updated Jan 24th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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