| NPI | 1942549795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN ELLSWORTH Owner, Manager 801-550-0955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: UT 8400193-0501) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2021-09-29 |