Healthcare Provider Details

I. General information

NPI: 1710817572
Provider Name (Legal Business Name): RYAN WESLEY OSGUTHORPE LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N BLUFF ST STE 23
SAINT GEORGE UT
84770-5491
US

IV. Provider business mailing address

920 E 3800 S
WASHINGTON UT
84780-1381
US

V. Phone/Fax

Practice location:
  • Phone: 801-867-4354
  • Fax:
Mailing address:
  • Phone: 801-867-4354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number9059262-4701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: