Organization
ELLSWORTH FOOT AND ANKLE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN ELLSWORTH DPM (OWNER, MANAGER)
(801) 550-0955
Entity
Organization
Contact information
Practice address
12523 S CREEK MEADOW RD STE 105, RIVERTON, UT 84065
(801) 253-6886
(801) 253-6888
Mailing address
12523 S CREEK MEADOW RD STE 105, RIVERTON, UT 84065-7299
(801) 253-6886
(801) 253-6888
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
8400193-0501
UT
Other
Enumeration date
02/13/2013
Last updated
09/29/2021
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