Individual
COLTON PALMER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2016 S WASHINGTON ST, GRAND FORKS, ND 58201-6342
(701) 757-4200
Mailing address
2016 S WASHINGTON ST, GRAND FORKS, ND 58201-6342
(701) 757-4200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396085718
—
UT
Enumeration date
04/26/2022
Last updated
11/10/2023
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