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Organization
AMBLE MEDICAL
Active
Organization
AMBLE MEDICAL
Active
Other names
Amble Medical
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN SCOTT ELLSWORTH DPM (CEO)
(801) 253-6886
Entity
Organization
Contact information
Practice address
9980 S 300 W STE 300, SANDY, UT 84070-3654
(801) 253-6886
Mailing address
9980 S 300 W STE 300, SANDY, UT 84070-3654
(801) 253-6886
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
207Q00000X
Family Medicine Physician
—
—
213E00000X
Podiatrist
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4106898
—
UT
Enumeration date
05/09/2022
Last updated
09/27/2024
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