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General NPI Number Information
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NPI Number | 1982496253
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Entity Type | Organization
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Legal Business Name | AMBLE MEDICAL
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Dates
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Enumeration Date | 05/21/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 340 FALCON RIDGE PKWY STE 401
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City | MESQUITE
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State | NV
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Zip | 89027-8851
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Country | US
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Telephone | 801-273-0001
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Fax |
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Provider Business Mailing Address
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Address Line | DEPT. 624 P.O BOX 30015
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City | SALT LAKE CITY
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State | UT
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Zip | 84130-0015
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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 | CEO
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Name | RYAN SCOTT ELLSWORTH
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Credential | DPM
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Telephone | 801-253-6886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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