COLTON JACKSON

SALEM, UT
NPI1942029152
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: UT  9420231-4405)
Enumeration Date2024-10-04
Last Update Date2024-10-04
Business Address
COLTON JACKSON NP
555 W STATE ROAD 164
SALEM, UT 84653-5732
Phone number: 385-203-2720
Mailing Address
COLTON JACKSON NP
1055 N 500 W ATTN: CREDENTIALING
PROVO, UT 84604
Phone number: 801-354-8225