Provider Demographics
NPI:1528275898
Name:OLLERTON, RYAN C (DO)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:C
Last Name:OLLERTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N 1220 E
Mailing Address - Street 2:SUITE # 7
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2089
Mailing Address - Country:US
Mailing Address - Phone:801-756-9635
Mailing Address - Fax:
Practice Address - Street 1:120 N 1220 E
Practice Address - Street 2:SUITE # 7
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2089
Practice Address - Country:US
Practice Address - Phone:801-756-9635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6564844-1204207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology