Individual
MR. GARRETT RYAN GUNDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
115 GOLF COURSE RD STE E, LOGAN, UT 84321-5934
(435) 999-4059
(435) 213-2800
Mailing address
12002 N 5600 W, CORNISH, UT 84308-1712
(208) 380-0251
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
12819884-1206
UT
Other
Enumeration date
08/28/2017
Last updated
03/28/2024
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