NPI 1699400762 · live from the CMS NPI Registry
Ellsworth Foot And Ankle Clinic
Podiatrist in West Valley, UT. National Provider Identifier 1699400762, active.
NPI record
| NPI | 1699400762 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 3715 W 4100 S Ste 150, West Valley, UT 84120 |
| Practice phone | 801-253-6886 |
| Mailing address | 9980 S 300 W Ste 310, Sandy, UT 84070 |
| Enumerated | July 21, 2022 |
| Last updated | July 21, 2022 |
| Authorized official | Ryan Ellsworth, Ceo |
| Other names | Summit Foot And Ankle |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist primary | 213E00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.