Individual
RYAN DON GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT CHT
Contact information
Practice address
2310 N 400 E STE D, NORTH LOGAN, UT 84341-1788
(435) 774-8562
(435) 774-8582
Mailing address
71 EAST CENTER, CLARKSTON, UT 84305-0123
(435) 787-9030
(435) 787-9033
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
03335214201
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D3647
—
UT
Enumeration date
02/02/2007
Last updated
11/22/2019
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