Individual
COLTON WAYNE DICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
5415 N FOSTER RD APT 8306, SAN ANTONIO, TX 78244-2405
(903) 293-7908
Mailing address
5415 N FOSTER RD APT 8306, SAN ANTONIO, TX 78244-2405
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
06/18/2020
Last updated
06/18/2020
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