NPI 1063812592

Ryan Willis, MSATCLCES

Practitioner Athletic Trainer Salt Lake City, UT

Practice location

Address: 5670 W Red Ridge Ln, Salt Lake City, UT 84118-5004
Phone: (801) 865-1239

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 7913172-4810 (UT)

Other Specialist/Technologist providers in Utah →

Registry record

NPI: 1063812592
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Sep 2014
Record last updated: 3 Sep 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.