Individual
MARISA ANN RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3000 N TRIUMPH BLVD STE 260, LEHI, UT 84043-4999
(801) 768-3500
(801) 768-3506
Mailing address
1055 N 300 W STE 401, PROVO, UT 84604-3306
(801) 357-7499
(801) 373-5980
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
047679149
CT
207Y00000X
Otolaryngology Physician
Primary
12974559-1205
UT
207Y00000X
Otolaryngology Physician
88123
GA
207Y00000X
Otolaryngology Physician
D83114
MD
207YP0228X
Pediatric Otolaryngology Physician
12974559-1205
UT
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
88123
GA
Other
Enumeration date
04/29/2010
Last updated
03/05/2025
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