Individual
COLTON WILLIAM ROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 PHALEN BLVD, SAINT PAUL, MN 55130-5302
(952) 967-7977
(651) 254-8558
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14103
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/01/2022
Last updated
07/12/2022
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