Provider Demographics
NPI:1932719846
Name:WEHMHOEFER, ERIC RYAN (MS, OTR/L, MBA)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:RYAN
Last Name:WEHMHOEFER
Suffix:
Gender:M
Credentials:MS, OTR/L, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 E SANDHILL DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780
Mailing Address - Country:US
Mailing Address - Phone:701-226-6855
Mailing Address - Fax:
Practice Address - Street 1:1680 E SANDHILL DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-8308
Practice Address - Country:US
Practice Address - Phone:701-226-6855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8322882-4201225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist