Individual
RYAN DANIEL MCTISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(404) 313-3653
Mailing address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(404) 313-3653
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8296959-1701
UT
Other
Enumeration date
12/17/2017
Last updated
12/17/2017
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