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Individual

COLTON LAMONT BLACKHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
21260 N 1450 E, MORONI, UT 84646-0461
(435) 445-5200
(435) 445-5201
Mailing address
PO BOX 461, 21260 N 1450 E, MORONI, UT 84646-0461
(435) 445-5200
(435) 445-5201

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
UT

Other

Enumeration date
06/20/2011
Last updated
06/20/2011
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