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Individual

RYAN IKAIKA SELFAISON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
865 N 900 W, OREM, UT 84057-7701
(385) 236-5365
Mailing address
854 N 560 W, LEHI, UT 84043-3528
(808) 220-5329

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10261211-2401
UT

Other

Enumeration date
05/08/2025
Last updated
05/08/2025
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