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General NPI Number Information
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NPI Number | 1578026712
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Entity Type | Individual
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Provider Name | ELIZABETH NICHOLS RITTER MD
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Gender | Female
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Dates
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Enumeration Date | 04/12/2019
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 1716 US-40 SUITE 100
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City | HEBER CITY
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State | UT
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Zip | 84032
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Country | US
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Telephone | 801-758-0428
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Fax |
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Provider Business Mailing Address
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Address Line | 22 S 900 E
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City | SALT LAKE CITY
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State | UT
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Zip | 84102-1307
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Country | US
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Telephone | 801-758-0428
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 138417031205
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License Number State | UT
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