Individual
COLTON PHIPPEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1222
(801) 236-7710
Mailing address
500 S 11TH AVE STE 400, POCATELLO, ID 83201-4880
(208) 232-7962
(208) 232-2408
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MRO-2184
ID
Other
Enumeration date
03/08/2014
Last updated
07/07/2022
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