| Doctor Name: | RYAN DENNIS WIGHT |
| NPI Number: | 1609028943 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 2636 |
| Business Practice Address: | 3336 Pioneer Pkwy Suite 302 West Valley, UT - 841202000 |
| Business Phone Number: | 6173142172 |
| Business Fax Number: | |
| Mailing Address: | 3336 Pioneer Pkwy, Suite 302 WEST VALLEY |
| State: | UT |
| Postal Code: | 841202000 |
| Phone Number: | 6173142172 |
| Fax Number: | |
| NPI Enumeration Date: | 10/17/2008 |
| NPI Last Update Date: | 03/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 2636 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |