Healthcare Provider Details

I. General information

NPI: 1942115944
Provider Name (Legal Business Name): RYAN MATHEWS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1933 W 11800 S
RIVERTON UT
84065-7822
US

IV. Provider business mailing address

1933 W 11800 S
RIVERTON UT
84065-7822
US

V. Phone/Fax

Practice location:
  • Phone: 385-505-4321
  • Fax:
Mailing address:
  • Phone: 385-505-4321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: