Healthcare Provider Details

I. General information

NPI: 1295060085
Provider Name (Legal Business Name): RYAN DEAN MCGIVEN MS, OTR/L, CHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2009
Last Update Date: 03/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1992 W ANTELOPE DR STE 1D
LAYTON UT
84041
US

IV. Provider business mailing address

1992 W ANTELOPE DR STE 1D
LAYTON UT
84041-4974
US

V. Phone/Fax

Practice location:
  • Phone: 801-773-2633
  • Fax: 801-773-1553
Mailing address:
  • Phone: 801-773-2633
  • Fax: 801-773-1553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number7465498-4201
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: