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NPI Code Detail

MEDICARE: RYAN TEKOLSTE

MEDICARE: RYAN TEKOLSTE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist12078806-2401UT
2225100000XPhysical TherapistPTL.0017202CO

General Provider Information

NPI Number : 1457964470
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN TEKOLSTE
Provider Business Mailing Address
First Line : 5121 S COTTONWOOD ST
Second Line :
City : MURRAY
State : UT
Zip : 84107-5701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5121 S COTTONWOOD ST
Second Line :
City : MURRAY
State : UT
Zip : 84107-5701
Country : US
Telephone Number : 801-507-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2020
Last Update Date : 06/27/2026

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Directions to “ RYAN TEKOLSTE ” Practice Location

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