Individual
MR. MARVIN T. COLYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
1333 S SAM HOUSTON BLVD, HOUSTON, MO 65483-2046
(417) 967-1265
(417) 967-1328
Mailing address
1333 S SAM HOUSTON BLVD, HOUSTON, MO 65483-2046
(417) 967-1265
(417) 967-1328
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
043360
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437104304
—
MO
01
—
26D0446923
CLIA
MO
Enumeration date
05/22/2006
Last updated
10/17/2016
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