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NPI Code Detail

MEDICARE: RYAN B ANDERTON MOTR/L

MEDICARE:   RYAN B ANDERTON  MOTR/L
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
1225X00000XOccupational Therapist5685969-4201UT
2225XP0200XPediatric Occupational Therapist5685969-4201UT
3225XP0019XPhysical Rehabilitation Occupational Therapist5685969-4201UT
4225XG0600XGerontology Occupational Therapist5685969-4201UT

General Provider Information

NPI Number : 1952283962
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN B ANDERTON MOTR/L
Provider Business Mailing Address
First Line : PO BOX 30180
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84130-0180
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1400 N 500 E
Second Line :
City : LOGAN
State : UT
Zip : 84341-2455
Country : US
Telephone Number : 435-716-6440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2025
Last Update Date : 01/13/2026

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Directions to “ RYAN B ANDERTON MOTR/L” Practice Location

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