Individual
RYAN K GARRITSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
324 E 10TH AVE, SUITE 100, SALT LAKE CITY, UT 84103-2853
(801) 408-8700
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 408-8700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9372775-1206
UT
363A00000X
Physician Assistant
PA9107450
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009948600
—
FL
01
—
P01275770
RAILROAD MEDICARE
FL
Enumeration date
09/20/2013
Last updated
04/22/2016
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