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General NPI Number Information
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NPI Number | 1952283962
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Entity Type | Individual
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Provider Name | RYAN B ANDERTON MOTR/L
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Gender | Male
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 1400 N 500 E
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City | LOGAN
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State | UT
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Zip | 84341-2455
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Country | US
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Telephone | 435-716-6440
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 30180
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City | SALT LAKE CITY
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State | UT
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Zip | 84130-0180
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Country | US
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Telephone |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5685969-4201
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 5685969-4201
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 5685969-4201
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number | 5685969-4201
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License Number State | UT
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