Individual
AUDRA RYSEVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 W 2100 S STE 130B, SALT LAKE CITY, UT 84115-1854
(801) 896-7930
Mailing address
140 W 2100 S STE 130B, SOUTH SALT LAKE, UT 84115-1854
(801) 896-1930
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
F25-117395
UT
Other
Enumeration date
02/25/2026
Last updated
02/25/2026
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