Individual
MR. CHAZ DERRICK COLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-2130
Mailing address
1346 E 3240 N, LEHI, UT 84043-3227
(801) 520-9049
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
8066563-4405
UT
Other
Enumeration date
08/24/2017
Last updated
08/24/2017
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