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1518484005
CHAZ DERRICK COLTON
PROVO, UT
NPI
1518484005
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: UT 8066563-4405)
Enumeration Date
2017-08-24
Last Update Date
2017-08-24
Business Address
Mr. CHAZ DERRICK COLTON DNP
1034 N 500 W
PROVO, UT 84604-3380
Phone number: 801-357-2130
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Mailing Address
Mr. CHAZ DERRICK COLTON DNP
1346 E 3240 N
LEHI, UT 84043-3227
Phone number: 801-520-9049
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