Individual
RYAN PATRICK RENKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2150 W 4800 S, ROY, UT 84067-1844
(801) 476-3600
Mailing address
5890 S 4550 W, HOOPER, UT 84315-6771
(231) 920-0924
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
8081236-4810
UT
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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