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1801457627
COLTON BRAD PETERSON
OGDEN, UT
NPI
1801457627
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: UT 11306023-1206)
Enumeration Date
2019-06-24
Last Update Date
2019-10-25
Business Address
COLTON BRAD PETERSON
4403 HARRISON BLVD STE 2400
OGDEN, UT 84403-3297
Phone number: 801-387-2750
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Mailing Address
COLTON BRAD PETERSON
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number:
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