Provider Demographics
NPI:1295060085
Name:MCGIVEN, RYAN DEAN (MS, OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:DEAN
Last Name:MCGIVEN
Suffix:
Gender:M
Credentials:MS, OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1992 W ANTELOPE DR STE 1D
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-4974
Mailing Address - Country:US
Mailing Address - Phone:801-773-2633
Mailing Address - Fax:801-773-1553
Practice Address - Street 1:1992 W ANTELOPE DR STE 1D
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041
Practice Address - Country:US
Practice Address - Phone:801-773-2633
Practice Address - Fax:801-773-1553
Is Sole Proprietor?:No
Enumeration Date:2009-10-12
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7465498-4201225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU000075150Medicare UPIN